HomeMy WebLinkAboutPotter permit appl.All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
gir FL UR
�x 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:
Adaress: ur!ttr 6u cur
Property Tax ID #: 3404-808-0010-000-2 Lot No.10
Site Plan Name: Block No.
Project Name: Driftwood Manor
Remove exisiting doors and install 16 x 7 DAB Hurricane Master model 824 +36/44
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: $ 1958.00 Utilities: —Sewer _ Septic Building Height:
1ER AE SEE:
m
CONTRACTOR:
Name Rebecca Potter _
Name: DeAnn Prue
Company: DoorsandmoreoftheTC.com
Address:1103 Driftwood Ln
Address: 837 S. Kings Hwy.
City: Ft. Pierce, FI.
City: Ft. Pierce State:Fl•
_
Zip Code: 34982 Fax:___-----
Phone No.772-332-6459
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
State or County License CRC131540
from the Owner listed above)
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.
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
DESIGNER/ENGINEER:
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 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, 1 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 attornev before commencine work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
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
this 3 CZ day of C-\ Q 2021 by
this day of �i 202Q by
Name of person making statement.
Name of person making statement.
Personally Known K OR Produced Identification
Personally Known _�S OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
`
`\
(Signature of Notary Public-.S' of on
Y COM ISSION # GG 237558
Signa ure of Notary Public- Sta
KAREN D'ONOFRI
Commission No. E�� S: August 5, 2022
Underwriters
;"
ommission No 96100MMISSION#GG2
Bonde hi otary Public
EXPIRES: August 5, 2
edc�°;.BaafiM Thru NotaryPublic Und
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. S/b/LU
Name
Address 1 l U
Street
Doors & More of the Treasure Coast, Inc.
City
837 S King's Highway
Ft. Pierce, FL 34945
P: (772) 409-4501
F: (772) 252-4633
www.doorsandmoretc.com
H ' � (4 �)S
Phone �— `Z LC E-mail
Door Size Model % �P �GA✓N lAAc. indload
Color: r" it „ and Brown Oak Cherry
Tear
Insulation
2X6 PTJa
OperatoruQ
''k'—`
Remotes: 1 3 Ra�- 7 Ft 18 Ft
KeyPad
Re hook-up to existing motor: Yes nNo)
f
Trim: es� No
Additional Notes: 0 uk-
,.F--v,
1--XI V - �
Accepted by Customer,
Signature
D�
,Q
$ i 1.
1C(�$ '
i
$
00
Permit
Subtotal $
ALAI
Deposit $
—1.6 00,
Balance $
Date