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HomeMy WebLinkAboutBuilding Permit ApplicationAl I APPI ICARI F INFn MUST RE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: _a co-0 I Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT APPLICATION FOR: Window/door PROPOSED IMPROVEMENT LOCATION :Address: 4804 Paleo Pines Circle Legal Description: Holiday Pines S/D Phase II - B Lot 308 Property Tax ID #-. 1312-801-0111-000-1 Lot No. Site Plan Name: Block No. Project Name: LLS Development Setbacks Front X Back: Right Side: Left Side: DETAILED DESCRIPTION OF -WORK: Remove and replace a 16 x 7 garage door Haamonai worKto ae 11HVAC 11 Electric errormea unaertnis permit—cnecK au n Gas Tank Gas Piping _ Plumbing Sprinklers apply: Shutters Windows/Doors Generator Roof _ ❑ Total Sq. Ft of Construction: Cost of Construction: $ 1,410.00 S Ft. of First Floor: _ Utilities: Sewer []Septic Building Height: OWNER/LESS E: CONTRACTOR: Name James And Sharon Dial Name: Simeon Spagnuolo Address: 4804 Paleo Pines Circle Company: ABCO Garage Door Company, Inc. City: Fort Pierce State: FL Zip Code: 34951 Fax: Phone No. 772-828-1905 Address: 670 8th Court City: Vero Beach State: FL Zip Code: 32962 Fax: 772-567-0894 Phone No. 772-567-9098 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: abcodoorvb@outlook.com State or County License: 27233 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPP(EMENTA'CGONS7RUCTION LIEN LAW INFORMATION: y DESIGNER/ENGINEER: _ Not Applicable ;Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: !Address: ;City: State: !Zip: Phone: City: State: Zip: Phone: IFEE SIMPLE TITLE HOLDER: _ Not Applicable jName: BONDING COMPANY: Not Applicable Name: Address: Address: City: City: .Zip: Phone: Zip: Phone: 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 jobsite ;before the first inspection. If you intend to obtain financing, consult with lender or an attorney before ;commencing work or recording your Notice of Commencement. -- s _ Signature of w Signature of actor/License Holder STATE OF FLORIDA STATE OF FLORIDA ' COUNTY OF Indian River COUNTY OF Indian River The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 23 day of January 20 20 by this 23 day of January 20 ?n by { Simeon Spagnuoi6- Simeon Spagnuolo (Name of person acknowledging) (Name of person acknowledging ) re of Notary P41ic- State of Florida ) Personally Known x v OR Produced Identification Type of Identification Produced Commission No. GG148342 Revised 07/15/2014 H(I �j Short NO�ARY PUBLIC STATE OF FLORIDA Comm# GG148342 Expires 5/25/2021 ature of Notary Rublic- State of Florida Personally Known x OR Produced Identification Type of Identification Produced Commission No. GG148342 *51 y e Short rA Y PUBLIC 1 STATE OF FLORIDA om GG148342 • HCE M1e Expires 5/25/2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS