HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR: Shutter
PROPOSED I0OVEM.`ENT LaCAT�01V
Y yz
Address: 13207 S Indian River Drive,Jensen Beach,F134957
Legal Description:
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Property Tax ID#:4509-120-0012-000-0 Lot No.
Site Plan Name: Block No.
Project Name:Audry Rollins
Setbacks Front Back: Right Side: Left Side:
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Replacement of// windows doors
CQNSTRUN�INFORMATION
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itiona wor to a Bar orme un ert is permit—c ec a appy: ,N
HVAC IJ Gas Tank Gas Piping _Shutters Windows Doors
❑ p g ❑Windows/
Doors
❑ Plumbing Sprinklers Generator' 0 Roof
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 23700.00 Utilities:11Sewer DSeptic Building Height:
Name Audry Rollins, Name:Alphonse P. Campanelli
Address: 13207 S Indian River Drive Company:Storm Tight Windows,Inc.
City: Jensen Beach State: Fl Address:500 SW 12th Aye
Zip Code: 34957 Fax: City:Deerfield Beach State:FL
Phone No. 804-513-8777 Zip Code: 33441" Fax:561-292-3562
E-Mail: Phone No. 561-536-4387
Fill in fee simple Title Halder on next page(if different E-Mail: storm tightpermits(u outlook.com
from the Owner listed above) State or County License:CRC046091
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is'required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: a
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certifythat no work or installation has commenced priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holderto 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
commenging work or recording our Notice of Commencement.
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Signatbre-of_O er/-Agent/-Les!ee Signature of Contractor/License Holcrer
STATE OF FLORH�Fk STATE OF FL6�
COUNTY OF 1 W�M COUNTY OFQRi�(o Yrs
The f Ding instrL nt was acknowledge _ efore me The for ng instrumJl n was acknowledged before me
this _day of 20�by this day of ,ZO by
i V�r --�U J tom—t,� 0 1 k
( e of person cknowledging) { e of p rson acknowledging)L�L= - (
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{Sldqa re of Notary PUJ116 State of Florida} {Sig re of Notary Pu ictljijbof Florida)
Personally Known OR Pr used I entification Personally Known�OR Produced Identification
Type of Identification Produced'r! Type of Identificatio Produced
Commission No. _ tSel), ,i Commission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA i'�ONI AT�f�TL`E iANn0"E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS