HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I J 2Q
Date: 11/14/19 Permit Number: `� ` •�3$�
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Building Permit Application pe,,�;tt� l ,.8 ,,•4 �19
Planning and Development Services St L!cgti 4c,9Il'p,
Building and Code Regulation Division o, ter. le �C9on13, nt
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE: ROLL UP DOOR
i?ROPQSED IIVII?RfJUEMENT LQCATIQN..
Address: 10961 S US HWY 1
FL # 12765.3 — \ _ C)� 6XA l l
r
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 2218.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
WNERJLESSE f
C4NTRACTC3ft -:e
Name MONDO PROPERTIES LLC
Name: DENVER MILLER
Address: 1169 FAULKNER TERR
Company: D&D GARAGE DOORS PSL
City: PALM BEACH GARDENS State: _
Zip Code: 33418 Fax:
Phone No. 772-323-5207
Address: 435 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:
Phone No 772-460-7630
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail TIFFANY@DDGARAGEDOORSPSL.COM
State or County License 19007
If value of construction is $2500 or more a RECORDED Notice of Commencement is ren—raA
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIC}"N'
.� v . �.
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: )6 Not Applicable
BONDING COMPANY: 1CNot Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign ture of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF,f5\--
COUNTY OF '-�— \_y f_,
The forgoing instru ent was acknowledged —before me
P��
The for oing inst((um�ent was acknowledged before me
��
this day of \� 20 by
this day of 20Aaby
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
\LAC' ,tea 0 \ �/�Ji .
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(Signature of Notary P lic-State of Flo d )
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(Signature of Notary Public- tate of F�t3�'i4�¢,'� F EfiZG
R
,tsy PQ9 TIFFANY METZGER
Commission No.I)
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19