HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
Address: 6500 Sebastian Road, Ft. Pierce , FI. 34951
Property Tax ID#: 1301-613-0390-000-9 Lot No. 2
Site Plan Name: Block No.
Project Name: Lakewood Park
DETAILED DESCRIPTION OF WORK: -
Remove existing garage door and haul away, Install new Dab Hurricane Model 824 white RIP WJL +36/-44
/(' k`t
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: $ 2,465.00 Utilities: —Sewer _Septic Building Height:
Namerank Fulknier Name: DeAnn Prue
Address:6500 Sebastian Rd. Company: Doors& More of the Treasure Coast, Inc.
City: Ft. Pierce State:J-�(_ Address: 837 S. Kings Hwy.
Zip Code: 34951 Fax: City: Ft. Pierce State: FI.
Phone No.772-473-9541 Zip Code: 34945 Fax: 772-252-4633
E-Mail: Phone No 772-409-4501
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 CRC-1331540
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.
Doors & More of the Treasure Coast, Inc.
qgiirs 837 S King's Highway
Ft. Pierce, FL 34945
P: (772) 409-4501
Doors & More F: (772) 252-4633
www.doorsandmoretc.com
QUOTE
Name rU ►'li e✓
Address �DU �� 1r•1Dv'� v%
Street City
Phone �1 -- -- 5� E-mail
Door Size (a X / Model ( U C4v Windload
N��S•l-P-� .DC"�
Color: �ite Almond Brown Oak Cherry $r�/90
Tear Out $ 4L
Insulation $
2 X 6 PT Jambs`/-�Pe_ Ue- ( Vf GZr- C�� �'''A $ `
CLAA t )(6 F- ti-
Operator V. —
Remotes: Rail: 7 Ft '8 Ft
KeyPad / $ `J
Re hook-up to existing motor: Yes(/-
Trim: Yes j No $
Additional Notes: IS-\5 W� w k x)" C�edCc__
Q� :jOP- - ad Las, er
Permit $ IP0
Subtotal $
�
� � tom,
Deposit $ 00
Balance $
Accepted b Cu '�" � �p y Customer Date
Signature
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
STATE OF FLORIDA
COUNTY OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this 3 day of 20_!DAL by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
Signature of Notary Public-State of Flo 'd )
KAREN D'ONOFRIO
Commission No. (Seal) My COMMISSION#GG 237558
'ter P...... EXPIRES:August 5,2022
�G a�`� '�•°".`O'' Bonded Thru Notary Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev