HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 711116 Permit Number:
COLI NT o1. n
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7721462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 5305 PALED PINES CIR
Legal Description: HOLIDAY PINES PHASE 2B
Property Tax ID #: 1312-801-0158-000-2
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OUT AND REPLACE GARAGE DOOR 16X7
Lot No. 355
Block No.
CONSTRUCTION INFORMATION:
Additional work to be enofined under this permit— Check all W3L apply:
❑HVAC nGas Tank ❑Gas Piping LJ Shutters Windows/Doors11 L
Electric ❑ Plumbing Sprinklers Generator 1:1Roof
Total Sq. Ft of Construction: 5Ft. of First Floor:
Cost of Construction:$ 116000 Utilities:cn Sewer D Septic Building Height:
OWNER/LESSEE:
Name JASON THOMAS
Address: 5305 PALED PINES CIR
City FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone No. 772-216-3535
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: DENVER MILLER
Company: D & D GARAGE DOORS PSL
Address: 435 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:
Phone No. 772-460-7630
E -Mail: TIFFANY@DDGARAGEDOORSPSL.COM
State or County License: 19007
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER:
x Not Applicable
MORTGAGE COMPANY:
x Not Applicable
Name:
Name:
Mr" TIFFANYA.LEE
F+""4'S
Address:
°":°`¢ TIFFANY A.LEE
Address:
COMMISSION t FF 101474
(dad
City:
State:
City:
State:
Zip: Phone:
_
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
x Not Applicable
BONDING COMPANY:
x Not Applicable
Name:
Name:
ZONING SUPERVISOR
Address:
SEA TURTLE MANGROVE
Address:
REVIEW REVIEW
City:
REVIEW REVIEW ,
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 antl 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 final..ing, consult with lender or an attorney before
commencing work or recording your Notice of Comme icement. -_
Signature of Owners Lessee/Agent Signature of Contractor/License Halder
STATE OF FLORIDA
COUNTY OF s* wclE
The forgoing instrument was acknowledged before me
this I day of __Vu\ ` . 20 N by
DENVER MILLER'
(Name of person acknowledging I
(Sure of Notarypuli(icvtate of Florida0� I
STATE OF FLORIDA
COUNTY OF—
nuc,-The forgoing instrument was acknowledged
11 before me
this ', day of �\ s.�� .20 L by
DENVER MILLER
(Name of person acknowledg`in'g`)
(Sire oiNo9[ate of Florida I
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Mr" TIFFANYA.LEE
F+""4'S
°":°`¢ TIFFANY A.LEE
Commission No. rr10in4
COMMISSION t FF 101474
(dad
Commission Na. FF101474
" 1$e0IjC061MISSI0h i IF 101474
" EXPIRESApril 26.2018
a am!°4inmau4oNNoury Senees
EXPIRES. AF626.201B
Revised 07/15/2014
REVIEWS FRONT
ZONING SUPERVISOR
PLANS VEGETATION
SEA TURTLE MANGROVE
COUNTER
REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW ,
DATE
COMPLETE
INITIALS