HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL 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
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
[L
Address: IV maCC e .c F1 T
Legal Description: "hggpl)2 QID[TG - PLAT ?7 Stuep '43 Yc4 �tu i ¢. UNIT U
Property Tax ID #: L Ll �L,- )703- Ooxi -ey[ - d Lot No.
Site Plan Name: Block No.
Project Name: _Gr_&E K
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE/REPLACE( ( ) 8*% GaAC,4t
CONSTRUCTION INFORMATION:
Aciclitional work to � orme under this permit -check a app y: ❑ GARAGE
HVAC Gas Tank jU—jGas Piping _ Shutters X Windows/Doors
U Electric ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction: SZ.P Ft. of First Floor:
Cost of Construction: $ Ig79"' Utilities: Sewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ck
Name: GREGG DAVIS
Address: (PUP P Hit/ S ga
Company: BROTEN GARAGE DOOR SALES
City: State:
Address: 886 S. ANDREWS AVENUE
Zip Code: 3 Fax:
City: POMPANO BEACH State: FL
Phone No. OT&O G ► -'0c S
Zip Code: 33069 Fax: (954) 946-5587
E-Mail: l w::hof q /YIA-f I UM
Phone No. (954) 946-5555 EXT 127
Fill in fee simp`� le Title Holder on next page (if different
E-Mail: PERMTTS@BROTEN.COM
State or County License: CGC1514103
from the Owner listed above)
If wlue of construction Is $25W or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
1 MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 an yy applicable Home Owners Association rules, bylaws or and covenants that may restrictor prohibit such
structure. Please consult wRh 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing consult with leader or an attorney before
Lessee/Agent
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF '_RV I COUNTY OF BROWARD
The forgoing instrument was acknowledged before me
this is7 day of AwaugT- 202-l_-by
La`\\\t%IiI II II cz.� Gebae E.
me me o�acknowledeiae-l�.'-,N%,�.4�0 IAi
re of Notary
Personally Known OR
Type of Identification Produces
Commission No.
Revised 07/15/2014
My Comm. E>tpiree _
November 18, 2023
(Seal)
The (eWmg ins uAe�lj y+5�cknow, 20 before me
this�'�1 da o (S{( 20 � b
��(+ A nV
of person
:nature of Notary Public- State:o*flp
Personally Known X— OR
Type of Identification Producei
Commission No.
"Hf i 1
(Seal
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