HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE NFO ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a
Date: Permit Number:id,9 M
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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/door
PRQPQSED IMPROVEMENT LQCATlON
Address: 352 Ashley St
Legal Description: Replat of Palm Gardens
Property Tax ID#: 3403-802-0079-000-2 Lot No. 11
Site Plan Name: Block No. 6
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIQN 01= WC?RK
Tear out and replace 9x7 garage door
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CONSTRUCTION INFORMATION.,
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Additiona workto a er orme un er t is permit—c ec a appy:
HVAC M Gas Tank []Gas Piping OGenerator
Shutters QWindows/Doors
Electric 0 Plumbing Sprinklers Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1748.00 Utilities:n Sewer Septic Building Height:
fJWNERJj(.ESSE CONTRACTOR
Name Cecile Harris Name: Denver Miller
Address:8072 Spendthrift Ln Company: D & D Garage Doors PSL
City: Fort Pierce State:FL Address: 435 NW Enterprise Dr
Zip Code: 34986 Fax: City: Port St Lucie State: FL
Phone No.772-519-0775 Zip Code: 34986 Fax: 772-460-7630
E-Mail: Phone No. 772-460-7635
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.
SUPPLEfUIfNTAL CONSTfllCTfaN LIEN LAtN'INI+fJRNIA►TI£),IV�
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 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 recordingyour Notice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Con ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me
this 2 day of �� � 20/5 by this 2 day of OCTOBER 205 by
DENVER MILLERL DENVER MILLER
(Name of person acknowledging) (Name of person acknowledging)
Q-91-1
(Signature of Notary— P�tate of Florida) (Signature o Notary Public- tate 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 a°t;��� al TIFFANY A.LEE Commission No. FF10147a �ot�R;;�F (Seal)TIFFANYA.LEE
Y COMMISSION#FF 1014 4
* * * * MY COMMISSION#FF 101474
EXPIRE.(;-April 96 2018
N EXPIRES:April 26,2018
lFOF FLS one rU Budget Notary der9 OF 9TFOF F�OQ\O Bonded Thru Budget Notary Services
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS