HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application
Planning and Development Services JAN 17 2016
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
PRQPOSED INIPROVEMENTyLOCATON
t. .
Address: 5810 SHANNON DR
Legal Description: LAKEWOOD PARK UNIT 11
Property Tax ID#: 1301-613-0056-000-6 Lot No.7
Site Plan Name: Block No. 139
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Tear out and replace 12x7 garage door
CONSTRUCTION INFORMATION
Additionalwork toe e orme under this permit—check a appy:
HVAC Ei Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric ❑ Plumbing F]Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 1023.00 Utilities:n Sewer Septic Building Height:
OWNER/LESSEE r CONTRACTOR
.. . .
Name BRIGITTE HILL Name: DENVER MILLER
Address:5810 SHANNON DR Company: D&D GARAGE DOORS PSL
City: FORT PIERCE State:FL Address:,435 NW ENTERPRISE DR
Zip Code: 34951 Fax: City: PORT ST LUCIE State:FL
Phone No.304-237-7488 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.
SUPPLE ,LIEN LAW INFQRMATIQN f J ,
u �._
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,
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
Si nature of Owner/Lessee/Agent Signature of Contract r/License Holder
STATE OF FLORIna STATE OF FLORIDA,,
COUNTY OF UACG'C_ COUNTY OF
Thefor oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of20 Eby this day of_,SOJCNy�Cy .20 \`Pby
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public- ate of Florida) (Signature o Notary Public- ate of Florida)
Personally Known ✓ OR Produced Identification Personally Known "" OR Produced Identification
Type of Identification Produced Type of Identification Produced
-
Commission No. 1�E �����`\ ��Se�J� Commission No. FTC\C`�O"A (Seal)B
TIFFANY A.L R�•.�% TIFFANY A.LEE
* * MY COMMISSION#FF 101474 * MY COMMISSION#FF 101
EXPIRES:April 26,201E
281
Revised 07/15/2014
N�4TFOF F�O�\oP Bonded Thru Budget Notary Services N�'vreoF FroPNO' Bonded Thru Budget Notary Servi
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS