HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/9/2017 Permit Number:_11d3d dill
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RECEI`.'Ti7 ;.; R 0 2017
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
PRO{RASED tMPROVEMENI'rLOCATION
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Address: 5109 E Echo Pines E Cir., Fort Pierce, FL 34951-3319
Legal Description: HOLIDAY PINES S/D-PHASE II-B-LOT 400 (MAP 13/13N) (OR 3955-1051)
Property Tax ID#: 1312-801-0203-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
'DETAILED DESCRIPTION F WORK
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Replace existing windows w/PGT 5400 series non-impact insulated white vinyl windows. Replace
existing glass in sliding glass door with 5/8" over all clear insulated tempered. ;"4
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Acid itional work to be neFrTormed under this permit c ec all appy:
HVAC Gas Tank E]Gas Piping _Shutters Windows/Doors
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11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 8,150.00 UtilitiesInSewer Septic Building Height:
OWN,ERf LESSEE" d ?f ��� �`
Name Harold W Pitzner Jr Name: Daniel W Beard
Address:5109 E Echo Pines E Cir. Company: Vero Glass & Mirror
City: Fort Pierce State:FL Address: 1669 Old Dixie Hwy
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.732-742-9888 Zip Code: 32960 Fax: 772-562-1474
E-Mail:pitzstop@comcast.net Phone No. 772-567-3123
Fill in fee simple Title Holder on next page (if different E-Mail: danb@veroglass.com
from the Owner listed above) State or County License: SCC131151280
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUMP,P,,LEIVIENTAL C0N5TRUCT10 LIEN LAIN IMFaRMATION
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 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
commencing work4w+ecording your Notice of Commencement.
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_Signature of Owner/Lessee/Agent ` Signature of Contractor/License Holder
STATE OF FLORIDA -60 STATE OF FLORIDA C�
COUNTY OF =s --- � L V�e COUNTY OF � --��
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of h,nA�,g,� , 20 Lby this - day of 20 1"1 by
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(Name of person acknowledging) (Name of person acknowledging)
(Sig re otary Pub ic-State of Florida) / Signat a of N' tary Public-State of Florida)
Personally Known OR Produced Identification V Personally Known OR Produced Identification
Type of Identification Produced Qft`\\ -exr't�) I c Type of Identification Produced
Commission No.TV a` 'IUIo 5-1 (Seal) Commission No.1-1-may LQ(05, (Seal)
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Revised 07/15/2014 .'r W COMMISSION#FF246657 MY COMMISSION#FF246557
EXPIRES July 05,2019l.'.'.-. EXPIRES Juiy 05.2019=.;;;
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