HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 717116 Permit Number:
"S
ill -&A-01111111
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
PRnpn F:r19MPRr NfFMFNT I nrATinN•
Address: 179 NE BRACKEN RD
Legal Description: RIVER PARK UNIT 9
Property TaxlD#: �L��Q-��]O-��)��{-C- '7`B` Lot No.1
Site Plan Name: Block No. 74
Project Name:
Setbacks Front Back: Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK: III
TEAR OUT AND REPLACE 9X7 GARAGE DOOR
CONSTRUCTION INFORMATION: III
Piping
L-1
GasTank
ILaIHVAC
L (Electric
0 Plumbing
Total Sq. Ft of Construction:
❑ Generator
Cost of Construction:
$ 1155.00
Piping
1-1 Shutters
Z
Windows/Doors
nklers
Company: D&D GARAGE DOORS PSL
❑ Generator
Address: 435 NW ENTERPRISE DR
❑
Roof
Sq. Ft. of First Floor:
UtilitiesIl Sewer❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LOYD SYBERT
Name: DENVER MILLER
Address: 3213 RIVER DR
Company: D&D GARAGE DOORS PSL
City: FORT PIERCE State: FL
Zip Code: 34981 Fax:
Phone No. 772-999-1885
Address: 435 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax: 772-460-7635
Phone No. 772-460-7630
E -Mail:
Fill in fee simple Title Holder on nextpage ( if different
from the Owner listed above)
E -Mail: TIFFANYQDDGARAGEDOORSPSL.COM
State or County License: 19007
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
Name:
Address:
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
COMPANY: x Not Applicable
Name: _
Address:
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
_ Signature of Owner/ Lessee/Agent Signature of Contra r/LIc nse Halder
STATE OF FLORIDA
COUNTY OF sr Lucie
The forgoing instrument was acknowledged before me
this 1 day of ��s��F . 20 �by
DENVER MILLER'
(Name of person acknowledging
STATE OF FLORIDA
COUNTY OF sr Lucie
The forgoing instrument was acknowledged before me
this day of 20 0b by
DENVER MILLER
(Name of person acknowledging )
(Signature of Notary Public - Stat of Florida I
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. rFrmnn _ .. (Seal) I Commission No. FFIC1474
Revised 07/15/2014 ',7nd N,IAR.
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