HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1r' 116 Permit Number:
E - -, RECEIVED FEB 16 2016
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
P.ROPOSEO IMPROVENIENT LOCATIaN ~`
Address: 1309 PARKLAND BLVD
Legal Description: RIVERDALE YACHT CLUB ESTATES
Property Tax ID#: 3409-703-0142-000-9 Lot No.4&5
Site Plan Name: Block No. 22
Project Name:
Setbacks Front Back: Right Side: Left Side:
QETAILE'D QESCRIPTlON OFIIUORK ;
4
TEAR OUT AND REPLACE 9X7 GARAGE DOOR
CONSTRUCTION INFORMATION
Additionalwork toa nertormed under this permit—check. a appy:
HVAC Ei Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 2102.12 Utilities:n Sewer[]Septic Building Height:
OWNERJLESSEE `CONTRACTOR
Name JAMES SMITH JR Name: DENVER MILLER
Address: 1309 PARKLAND BLVD Company: D& D GARAGE DOORS PSL
City: FORT PIERCE State:FL Address: 435 NW ENTERPRISE DR
Zip Code: 34982 Fax: City: PORT ST LUCIE State:FL
Phone No.464-0989 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.
S.C3F'aPLEMENTAI CONSTRUCTi0N.11EN LAW iNF }RMATiaN
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 Contractor/License Holder
STATE OF FLORID �-e STATE OF FLORIDA ����
COUNTY OF ` . — ��c COUNTY OF
The for oing instrument was acknowledged before me The forgoing instrumentas acknowledge`d before me
this I day of Tc—b 20 1bby this l ay of 20 1 by
(Name of person acknowledging) (Name of person acknowledging)
411—
(Signature—of
Notary PublidN State of Florida ) (Signature of Notary Public-St a of Florida )
Personally Known ✓ OR Produced Identification Personally Known I""' OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. d` �`v`� 1�{o�PRl71) Commission No. r� aYa�B (Seal)
r ;• ., c TIFFANY A.LEE ro;...,•�i� TIFFANY A.LEE
MY COMMISSION N FF 1 1474 * MY COMMISSION 8 FF 101474
EXPIRES!April 26,2018
Nf-'rFOF,t60F Bondod7hru Budget Notary Servic'uLuTues N'aT c�°P 8andad Thru Budget Notary Services
Revised 07/15/2014 -OF FVO\
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS