HomeMy WebLinkAboutScan_2016_12_22_12_00_26_953ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/22/16
Permit Number:
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
PRCI (?<C ED I tt ?R(3VEEN LOCATI'd ';:> :::",=; :::,,:<.:::
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Address: 5949 ALEXANDRIA CIR
Legal Description: PALM GROVE
Property Tax ID #: 3410-503-0181-000-4Lot No. 12
Site Plan Name: Block No. F
Project Name:
Setbacks Front Back: Right Side: Left Side:
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TEAR OUT AND REPLACE 16X7 GARAGE DOOR
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Additional work to be� ertormed under this permit —check all ` h apply:
OHVAC Gas Tank E]Gas Piping _ Shutters Windows/Doors
❑ Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 1480.00
S Ft. of First Floor:
Utilities: 11Sewer Septic Building Height:
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Name HELEN LEIN Name: DENVER MILLER
Address: 5949 ALEXANDRIA CIR
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No. 772-460-7948
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
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.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone:
X Not Applicable
State:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY:
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.
x Not Applicable
State:
X Not Applicable
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 your Notice of Commencement.
Signatuie of Own er/Less'ee/ConCractor as Agent for Owner
STATE OF FLORID
COUNTY OF �� ,
The forgoing instrument was acknowledged before me
this�day of 20 Eby
(Name of person acknowledging)
(Signature of Notary Public- ate of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
thisQ�-day of 20 � by
(Name of person acknowledging )
(Signature of Notary Public- St to of Florida )
Personally Known ✓ OR Produced Identification
Type of Identification Produced
ZPFY ? F' P 0 (,A--) 0.Y PU
Commission No.°,• »$°eal) TiFFANYA.LEE Commission No. ot,.•»,e�%(Seal))TIFFANYA.LEE
* * MY CONIMISSION # FF 10'474
MY COMiJ1SSI0N # FF 101474
EXPIRES: April 26,20- 8 EXPIRES: April 26, 2018
Bonded Thru Uget Notary Services
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS