HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j, r
Date:
Permit Number:
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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
PROPOSED IMPROVEMENT LOCATION
Address: 705 KITTERMAN RD
Legal Description: MOEDL LAND CO'S
Property Tax ID#: 3415-501-0040-000-3 Lot No.3
Site Plan Name: Block No. 3N
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
TEAR OUT AND REPLACE (2) 9 X 7'6" GARAGE DOORS
CQNSTRUCTION INFORMATION
Additionalworkto e e orme un e
d er.t is permit–check a apply: '
s .
HVAC Gas Tank
—]Gas Piping _Shutters a Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator E] Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2490.00 Utilities:cn Sewer ESeptic Building Height:
01NNERJLESSEE NTR
r COACTOR
Name SOUTHEAST FLORIDAL BEHAVIORAL HEALTH NETWORK Name: DENVER MILLER
Address:140 INTRACOASTAL POINTE DR SUITE 211 Company: D&D GARAGE DOORS PSL dba GARAGE DOOR DEPOT
City: JUPITER State:FL Address: 435 NW ENTERPRISE DR
Zip Code: 33477 Fax: City: PORTS T LUCIE State:FL
Phone No.772-216-3003 Zip Code: 34952 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.
SUPPLEMENTAL,CONSTRUCTION INFqRATION
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 thepermit 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,
accessoy 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.
_Signature of Own er/•Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
Theforgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this of day of 20 \5 by this day ofNome n� ,20 WS, by
DENVER MILLERL DENVER MILLER
(Name of person acknowledging) (Name of person acknowledging)
(Signature of INTotary Publi -State of Florida) (Signature of Notary Public-St to 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 2p�°R:Pu6'1 (S IFFANYA.LEE Commission No.
FF101474 SPRY Pu _eal)
* my U MMISSION#FF 101474 �o;••.., V TIFFANY A.LEE
EXPIRES:April 26,2018 * MY COMMISSION#FF 10147
Revised 07/15/2014 ArFOFFLOQ Cn EXRIRES;April 26,20113
OFF��P\oP Bonded Thru Budget Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
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