HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/3/16 Permit Number:
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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
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Address: 4820 CHRISTENSEN RD
Legal Description: WHITE CITY
Property Tax ID #: 3403-502-0148-300-9 Lot No.
Site Plan Name: Block No.
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 nertormed under t ispermit — check all appy:
HVAC Gas Tank Gas PipingM Shutters Q Windows/Doors
❑ Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1360.00 Utilities: 0 Sewer 0Septic Building Height:
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Name KATHRYN BOER
Name: DENVER MILLER
Address: 4820 CHRISTENSEN RD
Company: D & D GARAGE DOORS PSL
City: FORT PIERCE State: FL
Address: 435 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34981 Fax:
Phone No. 772-834-1587
Zip Code: 34986 Fax:
E -Mail:
Phone No. 772-460-7630
Fill in fee simple Title Holder on next page ( if different
E -Mail: TIFFANY@DDGARAGEDOORSPSL.COM
State or County License: 19007
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: X Not Applicable
Name: _
Address:
City: _
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
State
x Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
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 vour Notice of Commencement.
s
Signature of Owner/Lessee7Contrattor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLOR
COUNTY OF . L "_K( e. COUNTY OF t\'.
The forgoing instrument was acknowledged before me
this _'_� day of�,, Ut_ .Cy , 20 aby
DENVER MILLER -
(Name of person acknowledging )
The forgoing instrument was acknowledgelId before me
this 3 day of 20 by
DENVER MILLER
(Name of person acknowledging )
(Signature of Notary Public- S ate of Florida) (Signature
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. FF101474 ,'Pay POB, eal) TIFFANY A. LEE
* MY COMMISSION k FF 1
Bonded Thru Budget Notary Services
Revised 07/15/2014
ry Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. FF101474 SPRY PU SeaI)
e° ••» % TIFFANY A, LEE
Q MY COMMISSION k FF 1
Bonded Thru Budget Notary Serlices
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