HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/14J2015 Permit Number:
.
SEP 142015
RECEIVED
ffinamumamw 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 fiNlPROUEMENT LOCATION: :,
Address: 5511 Paleo Pines Circle, Ft. Pierce, FL 34951
Legal Description: HOLIDAY PINES S/D-PHASE I-LOT 8(MAP 13/12S) (OR 568-1143; 2943-762)
Property Tax ID#: 1312-500-0009-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIE'TlON-':OF WORK
3
Remove & Replace 16 x 7 Garage Door
CC�NSTRUCT[ON [NFORMATION. . 3,
e
Additional work to e e orme under this permit–c ec a appy:
❑HVAC Ei Gas Tank Gas Piping Shutters �. Windows/Doors
❑ —
11Electric0 Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 1,175.00 Utilities:n Sewer Septic Building Height:
OWNER/LESS3EE CONTRACTOR.
Name James&Martha Williams Name: Simeon Spagnuolo
Address:5511 Paleo Pines Circle, Company: ABCO garage Door Company, Inc.
City: Ft. Pierce State:FL Address: 670 8th Court
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.772-418-5189 Zip Code: 32962 Fax: 772-567-0894
E-Mail: Phone No. 772-567-9098
Fill in fee simple Title Holder on next page(if different E-Mail: abcodoorvb@outlook.com
from the Owner listed above) State or County License: 27233
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
5'UPPLEMENTAL CQNSTRUCTION LIEN LAW INFQRMATION'
,•__s_ _ . s ,�.,.__, _.. a
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:
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 Signature of Contractor/License Holder
STATE OF FLO ID STATE OF FLORID
COUNTY OF �11 COUNTY OF kC4_1 0-11/`Lr
The#qrr g instr nt as acl owledged efore me The for4�g inst merit was acknowledged before me
this l l`�d`ay of, Y 20by this 11 day of 20 by
Sl mter-� SI MKO SPag 0cu1 o
(Name of person acknowledging (Name of person ackno led ' g)
(Signature of No 7OR
Pulic-St to of Flo id ) (Signa re of Not `Public- for
ate of da)
Personally Known Produced Identification Personally Known vuOR Produced Identification
Type of Identification Produced Type of Identification Produced
r, +-+-10755
Commission No-f— _ �S� (Seal) Commission No. (Seal)
KELLY L �.t pd46 KELLY L MONEY 9M5
MY COMMISSION 0 FF MY COMMISSION A FF 90355
EXPIRES:July 26,2019
Revised 07/15/2014 N47.717-01* Bonded Thm Bin%et Nobry Services ``}+,�OFov�O! Bonded ThruBodgetNotarySery
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