HomeMy WebLinkAboutPERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
1-M 1ICLE(Z E ._
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G � Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:Garage door
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Address: 2405 River Hammock Ln
Property Tax ID#: 3404-313-0011-020-6 Lot No.
Site Plan Name: Block No.
Project Name: Farmer
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Replace 16x7 garage door
FL# 16546.1
New Electrical Meter Second Electrical Meter
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: $ 1300.00 Utilities: —Sewer _Septic Building Height:
Name Debra Farmer Name:Connie Grace
Address:2405 River Hammock Ln Company:D&D Garage Doors of PSL
City: Fort Pierce State: Address:435 NW Enterprise Dr
Zip Code: 34981 Fax: City: Port St Lucie State:FL
Phone No.772-529-1930 Zip Code: 34986 Fax:
E-Mail: Phone N0772-460-7630
Fill in fee simple Title Holder on next page(if different E-Mail Daisy@ddgaragedoorspsl.com
from the Owner listed above) State or County License31521
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.
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X 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.
Sign re of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA p
COUNTY OF ,g L-i�G+� COUNTY OF � 6
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S to(or affirmed)and subscribed before me of Swop to(or affirmed)and subscribed before me of
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Phv5ical Prese ce or Online Notarization Swop
Presence or Online Notarization
this day of J�- 2020 by this day of rte 2020 by
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Name of person making statement. Name of person making statement.
Personally Known J OR Produced Identification Personally Known l/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced /
(Signature of NotaryPublic-State of Florida (Si nature of Notar Pu ic-State of F d
J g Y �) MICHAEL W K
MICHAEL W K •''•''•�.P Commission#HH 08 9
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Commission No. y� * * Commission#HH 141 a � Expires February 2, 0
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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