HomeMy WebLinkAboutBuilding Permit Application ALL AP=NFO ST COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: [S—O �
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 x
PERMIT APPLICATION FOR: Window/door
PROPOSED:IMPRO\/EMENT:LOCATION
Address: 5702 PALEO PINES CIR
Legal Description: HOLIDAY PINES PHASE I LOT 32
Property Tax ID#: 1312-500-0033-000-6 Lot No.32
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
.DETAILED DESCRIPTION
TEAR OUT AND REPLACE 16X7 GARAGE DOOR
CONSTRUCTION INFORMATION
Additional work toe e orme under this permit—check a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1360.00 Utilities:12 Sewer Septic Building Height:
OWN ER/LESSEE - CONTRACTOR.
Name e—/1a- FxaoCGL. Name: DENVER MILLER
Address: Q,, P, , pony: D &D GARAGE DOORS PSL
City: 13bl3i�`N cs`c c�" State:VA Address: 435 NW ENTERPRISE DR
Zip Code: - x: City: PORT ST LUCIE State:FL
Phone No.772-618-0879 Zip Code: 34986 Fax: 772-460-7635
E-Mail: Phone No. 772-460-7630
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 19007
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALjCONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: 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 apermit 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 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 lender or an attorney before
commencingwork or recordingour Notice of Commencement.
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY O F ST LUCIE COUNTY OF ST LUCIE
The for May
instrument was acknowledged before me The forgoing instrument was acknowledged before me
this May of N\aV 20 Eby this 13 day of MAY 20 _by
DENVER MILLERL DENVER MILLER
(Name of person acknowledging) (Name of person acknowledging)
(Signature o Notary Public-kate of Florida) (Signature of tary Public-State of Florida)
Personally Known x OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
opo v Fv" TIFFANY A.LEE
Commission No. FF101474 `' : •. a Commission No. FF101474 of YF��Seal) TIFFANYA.LEE
* *�I'COMMISSION#FF 10147 � ' �•' c MY COMMISSION#FF 10147
sr o`
EXPIRES:April 26,2018
OFFS ��fFOF F1,OQ'\oT Banded Thru Budget Notary Services
Revised 07/15/2014
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