HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c� y
Date: 3d 5 Permit Number:
RECEIV I SEP S0 2015
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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/doory,.� P,
PROPQSED IMPROVEMENT LOCATIQN
f M y,
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Address: 3334 COLUMBRINA CIR
Legal Description: SAVANNA CLUB
Property Tax ID#: 3425-703-0031-000-8 Lot No.43
Site Plan Name: Block No. 11
Project Name:
Setbacks Front Back: Right Side: Left Side:
DERAILED DETION SCRIPOF WORK �p
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F,
TEAR OUT AND REPLACE 12 X 7 GARAGE DOOR
CONSTRt1CTION`INFORMATIO"N
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Additionalwork toe e orme under this permit—check a appy:
HVAC E]Gas Tank ❑Gas Piping Shutters Windows/Doors
E]Electric ❑ Plumbing Sprinklers Flenerator 1:1 Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 1580.00 Utilities: Sewer E]Septic Building Height:
OWNERJLESSEE� ,�� � ":CONTRACTOR
Name JAMES STRANGEL Name: DENVER MILLER
Address:1963 ORRIE LN Company: D& D GARAGE DOORS PSL
City: GREEN BAY State:WI Address: 435 NW ENTERPRISE DR
Zip Code: 54304 Fax: City: PORT ST LUCIE State:FL
Phone No.715-745-4557 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: TIFFANY@ DDGARAGEDOORSPSL.COM
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.
SCIPPLEMENTAL CONSTRUCTION LIEN.LAW]NFQRMAl'IONr x
..
x. �
� =. .. _ MORTGAGE
DESIGNER ENGINEER: x Not Applicable 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.
Ignature of Owner/Lessee/Agent Suture bf Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
Theforgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this arJday of fs 20 k5by this��Iay of 20 )a by
DENVER MILLER DENVER MILLER
(Name of person acknowledging) (Name of person acknowledging)
L
(Signature of otary Publi -State of Florida) (Signature oVTotary Publi State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF101474 Ry�eaI) Commission No. FF101474 (Seal)
s°�;••••e�% TIFFANY A.LEE PAY Poe, TIFFANY A.LEE
* MY COMMISSION#FF 10 474 ,� * MY COMMISSION#FF 101474
April6,2018 Npr26,2018
Revised 07/15/2014
N�ATFOF FLO�\Op Bonded Thru Budget Notary Se,vicee j''FOFFLo���P Bonded Thru Budget Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS