HomeMy WebLinkAboutBuilding Permit ApplicationBuilding Permit Application T N
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,ts�
Date: �n. C Permit Number: 1 �✓
RECEIVED
Igo d�C�DI _ JAN 0 5 1010
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Building Permit Application
Permitting Department
St, Lucie Count`j
Planning and Development Services
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:REPLACEMENT OF EXISTING GARAGE DOOR-
PROPOSED IMPROVEMENT LOCATION:
Address: 25710 ORANGE AVE
Property Tax ID#: 2112-241-0001-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING 16X7 GARGAE DOOR WITH A NEW 16X7 DAB MIAMI-DADE 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/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 1579 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameShane Mulvey Name:BRUCE KINKADE
Address:4680 Jorgensen RD Company:A CHAMPIONS GARAGE DOORS
City: Ft Pierce State:_ Address:544 SW LACONIC AVE
Zip Code: 34981 Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34953 Fax:
E-Mail: Phone N0772-871-5550
Fill in fee simple Title Holder on next page(if different E-Mail CHAMPIONDOORS@COMCAST.NET
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If 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 Signature of Contractor/License Holder
STATE OF FLORI ��}--) r STATE OF FLORID )
COUNTY OF � COUNTY OF • J
Sworn to(or affirmed)and subscribed before me of Sn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of 2020 by this day of 2020 by
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
(14 'PLux'X a �,- + •�
(Signature of Notar ublic-State of Florida) LJ (Signature of Notary Pu 'c-State of Florida)
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AUDREYB.HUMPCommisslon No. G 300817 Commisslo N "
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EXPIRES:
EXPIRES:March 6,2023
F�,;.• one ru o .ry ru i u M? y`o:'r; :' Dcnded Thru Notary Public Unde writers
REVIEWSR�N ZONING SUPERVISOR PLANS �/E6AN' GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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