HomeMy WebLinkAboutPERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t-I .-�Q •Zt Permit Number:
§11 IL �"NO
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential YES
PERMIT APPLICATION FOR: REPLACE GARAGE DOORS
Address: 3251 NW DOCKAGE WAY PALM CITY FL 34990
Property Tax ID #: yL31p5I000 It40CC& Lot No.
Site Plan Name: Block No.
Project Name:
RFPI ACF 9 C'ARA('F nOORS
Fl -* ILpIQ 1.25
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
Total Sq. Ft of Construction:
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Cost of Construction: $ 2-yV) • C�o Utilities: —Sewer —Septic Building Height:
NameALICIA BUTLER
Address:3251 NW DOCKAGE WAY
City: PALM CITY State: �I
Zip Code: 34990 Fax:
Phone No. 772-834-6160
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:CONNIE GRACE
Company: D&D GARAGE DOORS OF PSL
Address:435 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:
Phone No772-460-7630
E-Mail DAISY@DDGARAGEDOORSPSL.COM
State or County License s1521
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 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 FLORID ,
COUNTY OF �n+' Lu6 e
STATE OF FLORIDA .. i
COUNTY OF
Swgrn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this day of ►� PL ( 202� by
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day//of 2020 by
_cc�Ylt�a e V��tC2
(�Ylt7i 2 C,cCe
Name of person making statement.
Name of person making statement.
/
Personally Known V OR Produced Identification
Personally Known v OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signat re of Notary Public- State of Florida)
��/� -7 ?olt ;yov MICHAEL W
Commission No. &K ( * Commis"#HH
�g d Expires February 2,
Yooded Thru Budget Nlllry
(Signature of Notary Public- State of Flor��,�� M�HAELW ALZ
� ( �p'��,� 1 ",y
7�nmission No HO!' ?� * commisFebruarH
205 � p�� Expires February ,
81tr1018 p�C Bonded Thru Budget N
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ev. 5/6/20