HomeMy WebLinkAboutBourassa permit appl.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
91r.
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 replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 6625 Alemendra
Property Tax I D #: 1306-500-0174-000-7 Lot No.26
Site Plan Name: Block No. 50
Project Name: Spanish Lakes Fairways
Remove exisiting door and install new 16 x 7 DAB Hurricane Master model 824 white +36/-44 PSF
New Electrical Meter Second Electrical Meter
W.
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: $ $ 1805.00 Utilities: — Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR: 8
Name3effery Bourassa _ Name: DeAnn Prue
Address: 6625 Alemendra Company: DoorsandmoreoftheTC.com
City: Ft. Pierce State: >~! Address: 837 S. Kings Hwy.
Zip Code: 34951 Fax: City: Ft. Pierce State:Fl.
Phone No. (v0 i `- Li c1(~ ' �(5 I Zip Code: 32945 Fax:
Phone No 772-409-4501
E-Mail:
Fill in fee simple Title Holder on next page ( if different E-Mail deann@doorsandmoretc.com
from the Owner listed above) State or County License CRC131540
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:
_ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to ao the worK anu in ILdudLrurr CIS 161.11CcLcu.
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
..:aL. I 41•nrr,n.i knfnrn rnmmonrino wnrk nr rprnrriing vnur Notice of Commencement.
W rill ICII%AGi vI v.......—., ... .. ...... .._...
—'-------- -
0� OU, 44,,"
14,1,
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
-
COUNTYOF !� -I, , .c
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
j)�j day 202CI by
this aS� day of 202Q by
this of _
Name of person making statement.
Name of person making statement.
Personally Known �S OR Produced Identification
Personally Known _ _ OR Produced Identification
Type of Identification
Type of Identification
Produ ed
Produced
r
(Signature of Notary Public- State 1,
I �° KAREN D'ON7GG
natur f Notary Public- State of . KAREN Q'0 IN
� � ."
Fi. �� �MY COMMISSION
My COMMISSION
No. S (Seal) EXPIRES: Au u
37558 �g— EXPIRES: AugCommission
032�issi No. Thru Notary Pu
9
Bonded Thru Notary Puerwriters
[funded
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
REN D'ONOF
DATE
N� ' MY C
i
MMISSION # GG 237
58
COMPLETED
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Rev. 5/b/Zu y�c
' Bonded Thru Notary Public Underwriters
2375
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Treasure Coast Garage Door SpeClAhSt
QUOTE
r
Name e�
Address (� 14S
Street City
Phone 60 0 3- Lf -s r3 E-mail
Door Size I k 7 Model`s
Color: White Almond Brown Oak Cherry
Tear Out
ZI:nsulation
---- -'
2 X 6 PT Jambs
Operator
Remotes: 1 2 3
KeyPad
Re hook-up to existing motor:
Trim: Yes N
Additional Notes:
Rail: 7 Ft 8 Ft
Yes No
Accepted by Customer
�fiignature
kS l
Doors & More of the Treasure Coast, Inc.
837 S King's Highway
Ft. Pierce, FL 34945
P: (772) 409-4501
F: (772) 252-4633
www.doorsandmoretc.com
�ySsr
Windload A- 9> &
$
Permit $ C� o
Subtotal $ I� r� oo
Deposit $
Balance $
Date ,0, 3-cP4