HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 06/22/2016 Permit Number:
L' E a
9i
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
Li
PRtPQSED IIUPROVEIa/IENT LOCATION
Address: 5303 EAGLE DRIVE, FORT PIERCE, FL 34951
Legal Description: HOLIDAY PINES S/D-PHASE II-B- LOT 265 (MAP 13/12S) (OR 681-545; 1937-1896)
Property Tax ID#: 1312-801-0068-000-4 Lot No.265
Site Plan Name: HOLIDAY PINES Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
D7AILD DE5CRlPTION'OF WORK f
b t
REPLACE EXISTING 16X7 GARAGE DOOR WITH DAB HURRICANE MASTER MIAMI- ADE
APPROVED GARAGE DOOR.
CONSTRUCTNF
ION IORMATION
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Additional work to be er ed under t is permit—check all that appy.
11HVAC Gas Tank ❑Gas Piping Shutters ✓�Windows/Doors
0 Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,535.00 Utilities:tSewer Septic Building Height:
01tVNER/LSS.EE CONTRACTOR
NameJAMES B DEAN •,.......Name ,., „ ,.. ,. ..,. ..,, . _..,._. ... , ,..,.. _ .;
DENNIS J WITHEROW
Address:5303 EAGLE DR Company: REGATTA BUILDING &DEVELOPMENT LLC
City: FORT PIERCE State:FL Address: PO BOX 2587
Zip Code: 34951 Fax: City: VERO BEACH State:FL
Phone No.(772)985-7412 Zip Code: 32961 Fax:
E-Mail: Phone No. (772) 564-9220
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CGC-1520800
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL GONSTF ICTiON LIEN LAW iN"M- ATiON M,
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.:.. Not
App . , ,�,. MORTGAGE COMPANY: . N »Y,
DESIGNER/ENGINEER: x_Not Applicable x of 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 recording our Notice of Commencement.
s
_Signature of 0&1
n /Lessee/Agent Signature of mantra¢or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF INDIAN RIVER
The forgoyg instrument was acknowledged efore me The forgoigg instrument was acknowledged before me
thisc;o- —day of J V✓—t 20 by this o?6gay of V--e—- 20 (Q by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known X —OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced 3RMof Identification Produced
NOTARY PUBLIC DAVID a(0 NOTARY PUBLICUE
Commission No. i:7 i�'p20� I STATE OF FLO p�gommission No-ER q RAYMOND 1:1
Comm#FF19267 STATE OF FLORID
Expires 126.11,20119 ---- F11926M
Revised 07/15/2014 Expires 1/26/2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS