HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: do \\ \S Permit Number:
f jn RECEIVED AUG 112015
- 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 x Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED,IWROVEMENT LOCATION:` °
Address: 3700 Ave F
Legal Description: Garden City Farms 05 35 40
Property Tax ID#: 2404-608-0188-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION,OF,WORK -
Tear out and replace 14 x 166" roll up door
CONSTRUCTION fNFORMATION
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2478.00 Lltilities:nSewer 0Septic Building Height:
OWNER/LESSEE CONTRA -TOR: `
Name Southeast-Atlantic Corp Name: Denver Miller
Address:6001 Bowdendale Ave Company: D& D Garage Doors PSL
City: Jacksonville State:FL Address: 435 NW Enterprise Dr
Zip Code: 32216 Fax: City: Port St Lucie State.FL
Phone No.772-461-3383 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.
SU:PPLEIUIENTAL CQNSTRlI JI0N LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _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 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.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
commencing work or recording our Notice of Commencement.
s
_Signature of Owner Lessee/Agent Si ure df Contractor/ icen Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF StLucle COUNTY OF stLucie
The forgoing instru nt was acknowledged before me The forgoing instrument was acknowledged before me
this � day of AJS�, 20 Laby this ��day of�.G'y�k— ,20 �by
Denver Miller 1 Denver Miller
(Name of person acknowledging) (Name of person acknowledging)
(Signature-o(Signature—oT Notary Publi -State of Florida) (Signature of Notary Public-S to of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
a°t�"'uBZ' TIFFANY A.LEE
Commission No. FF101474 •" fSe Commission No. FF101474 tear P $ea') TIFFANY A.LEE
* COMMISSION#FF 10147
.:..Poe"'•.'�
NDN �pQ
EXPIRES;April 26,2018 * MY COMMISSION If FF 1014
ervicee of�°��°` pandedTf 11 Budget't lary Service
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS