HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8110116 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 1200 DRIFTWOOD LANE
Legal Description: DRIFTWOOD MANOR
Property Tax ID #: 3404-808-0004-000-7
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
Left Side:
Lot No.4
Block No.
I DETAILED DESCRIPTION OF WORK: II
TEAR OUT AND REPLACE 16X8 GARAGE DOOR
I CONSTRUCTION INFORMATION: III
❑_ HVAC U Gas Tank
L (Electric ❑Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1165.00
Piping
Shutters Windows/Doors
Generator 11 Roof
SgI�Ft.I of First Floor:
Utilities: Lel Sewer Oseptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name KENNETH LIPPARD
Name: DENVER MILLER
Address: 1200 DRIFTWOOD LANE
Company: D & D GARAGE DOORS PSL
City: FORT PIERCE State: FL
Zip Code: 34082 Fax:
Phone No. 772-370-7548
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 next page ( if different
from the Owner listed above)
E -Mail: TIFFANY@DDGARAGEDOORSPSL.COM
State or County License: 19007
IT value or construction IS p[Ggq or more, a KtCUKULD notice at Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
FRONT
DESIGNER/ENGINEER:
Name:
x Not Applicable
MORTGAGE COMPANY:
Name:
" Not Applicable
Address:
MANGROVE
Address:
COUNTER
City:
Zip: Phone:
State:_
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER:
Name:
x Not Applicable
BONDING COMPANY:
Name:
x Not Applicable
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
_ Signature of Owne-r/ I
STATE OF FLORIDA
COUNTY OF sr woe
The forgoing instrument was acknowledged before me
this\0 day of %k 201ioby
DENVER MILLER'
(Name of person acknowledging )
.�s
Sigmature ot ContractorContrac[or/fir
STATE OF FLORIDA
COUNTY OF in uoE
The forgoing instrument was acknowledged before me
this �0 day of r T ,20 k�, by
DENVER MILLER
(Name of person acknowledging )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF101474 "+o„,(Seal) TIFFANY A LEE Commission No. FF101474 o�w+=.4, (Seal)
TIFFANY A. LEE
F "f IAY COMMISSION B FF 101474
x MY COMMISSION t FF 10147d
Revised O7/15/2014 ee,n° Bon4dIDry 64E5!INPary0eni:es 4s`'?crno+sd 0[aJEdIDu9itltNohryY.ni:&
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS