HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/24/2020 Permit Number:
99.[LUCE A
RECEIVED
o NOV 2 4 2010
p D p Building Permit Application
b Permitting Department
Planning and Development Services St. Lucie County
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED'IMPROVEMENT LOCATION:
Address: 2991 YATES DR
Property Tax ID#: 2419-434-0003-000-6 Lot No.
Site Plan Name: GARAGE DOOR REPLACEMENT FOR 16X7 Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING 16X7 GARAGE DOOR WITH A NEW DAB MIAMI DADE 16X7 GARAGE DOOR
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters =Windows/Dobff _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1 5 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Marc M Ball Name:BRUCE KINKADE
Address:2991 YATES DR Company:A CHAMPIONS GARAGE DOORS
City: FT PIERCE State:_ Address:544 SW LACONIC AVE
Zip Code: Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34953 Fax:
E-Mail: Phone No7728715550
Fill in fee simple Title Holder on next page(if different E-Mail CHAMPION DOORS@COMCAST.NET
from the Owner listed above) State or County License20349
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
"., lf'value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx Not Applicable MORTGAGE COMPANY: xx Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: xx Not Applicable BONDING COMPANY: xx Not 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signatur of Contractor/License Holder
STATE OF FLORIDA / STATE OF FLORIDA
COUNTY OF tc-� 1N COUNTY OF
Swo n to(or affirmed)and subscribed before me of Sworr to(or affirmed)and subscribed before me of
sical Presenc or Online Notarization f' Ph 'cal Presenc or Online Notarization
this-2 �
day of o — 2020 by this day of �Q — 2020 by
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Name of person making statement. / Name of person making statement. /
Personally Known OR Produced Identification !� Personally Known OR Produced Identification 4
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(Signature of Notary Public-Stzlt of Florida) (Signature of Notary Public-State of Florida )
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state of Florida-GGa2700790 =' Comm'ss'on # GG 270079
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