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HomeMy WebLinkAboutBuilding Permit Application I I i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �r1 Date: Permit Number: • rr:�rr 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 PRo os�D Ii&RovEMENT�LocATIaN. F p Address: 12192 RIVERBEND LN Legal Description: BAY ST LUCIE .J Property Tax ID#: 4422-502-0024-000-3 !� Lot No.21 Site Plan Name: Ji Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ©ETAtl:ED DE5CRIPTI0N_-,,,,_,,OFWORK. TEAR OUT AND REPLACE 16'2 X 8 GARAGE DOOR ' �i CfJNSTRUCTiON INFORMATION ' 0 l . �. =�.�.. ..a � �. . r. . Arldiitiona wor toa nertormed un ert is permit–c ec all appy: HVAC Gas Tank E]Gas Piping _Shutters Vil Windows/Doors Electric E] Plumbing Sprinklers [i Generator —]Roof Total Sq. Ft of Construction: G S Ft.of First Floor: Cost of Construction:$ �� Utilities:CnSewer[]Septic !Building Height: . = CONTRALTO Name FRED LARGEY Name: DENVER MILLER Address: 12192 RIVERBEND LN Company: D& D GARAGE DOORS PSL City: PORT ST LUCIE State:FL Address: 435 NW ENTERPRISE DR Zip Code: 34984 Fax: City: PORT ST LUCIEState:FL Phone No.772-626-4086 Zip Code: 34986 Fax: 772-460-7635 E-Mail: Phone No. 772-460-7630 9 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. i Sl1PP1.EMENTAI.CQNSTRUCTIDN LIEN LAW INF;OrRMAT1U1 . , � .MORTGAGE COMPANY: , DESIGNER/ENGINEER: x Not Applicable �I X Not Applicable Name: Name: h Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: 'I J. FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable Name: Name: Address: Address: l City: City: I Zip: Phone: Zip: Phone: J !J 'I 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 holderlto 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 an, d 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 ignature of 0 ner/Lessee/Agent Signature of Contractor`/Licens'eiHold et STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF ;i The for oing instrum t was acknowledge pe�fore me The forgoing instrumentwas acknowledged before me this day of 20 1`aiy this day of � 20 �P by (Name of person acknowledging) (Name of person acknowledging) I (Signature of Notary Public-St to of Florida) (Signature of Notary Public-State Florida) 'I Personally Known LI/ OR Produced Identification Personally Known Vol OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. ��;:�P°a��Seal) TIFFANY A.LEE Commission No. 1— �`�` � �o�y- I * � MY COMMISSION#FF 101474 �. � ) TIFFANY A.LEE MY COMMISSION#FF 101 EXPIRES;April 26,2018 '� EXPIRES:April 26 201 ACOP F�o�, Bon*ThR budget NOWYrgTep o BondedThru Budget Notary Ser Revised 07/15/2014 I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW ;I REVIEW REVIEW DATE jI COMPLETE INITIALS II N A