HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICA It INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
r
E -CILS!7
')'7) 17 q
Date: o, Permit Number: r70G
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 dential x
PERMIT APPLICATION FOR: Window/door
CONTRACTOR
Additional work tobe nertormed under this permit- check
11HVAC E] Gas Tank OGas Piping
all apply:
In Shutters
PE 'T OCA I
P"Ro S.04
Windows/Doors
Electric 0 Plumbing F]Sprinklers
1:1 Generator
E]Roof
Address: 4706 Matanzas Ave Ft. Pierce FL.
Legal Description: Harmony Heights ADDN BLK B LOT 3 (OR 3985-311)
Property Tax ID #: 1431-701-0013-000-3 Lot No. 3
Site Plan Name: Block No. B
Project Name: Windows
Setbacks Front Back: Right Side: Left Side:
-d"
DETAILED ',,,,DESCRIPTION `OF ORK:'
Remove and replace (6) windows in Five opening. All window to be Impact Low -E windows
CONSTRUCTIONINFORMATION
10
CONTRACTOR
Additional work tobe nertormed under this permit- check
11HVAC E] Gas Tank OGas Piping
all apply:
In Shutters
Name:
Windows/Doors
Electric 0 Plumbing F]Sprinklers
1:1 Generator
E]Roof
Roof pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
—
Phone No. 192 - 4 7 1 - T-6 Y
G
Cost of Construction: $ 0 Utilities:
�p
[:]Sewer OSeptic
Building
Height:
I
R
OW- N E, S S, E E
CONTRACTOR
Name k) rc g_o LA�A \A -e WT
Name:
Address: LliCZ V"**NKAJ'9
1415
Company: ;Evp)
Address: W -' 2C
City: Ft State:
Zip Code: Fax:_
City:0- r _�_ State:
—
Phone No. 192 - 4 7 1 - T-6 Y
G
Zip Code: -1 cl Y 7 1 Fax: A
E -Mail:
Phone No.
Fill in fee simple Title Holder on next page if different
E -Mail:
State or County License:
from the Owner listed above)
If value of construction is $250 0.Or more, a RECORDED Notice of Commencement is required.'
FM10
SUPPLEMENTAL CONSTRUCTIO IEE LAIN INFORMATION
.. r :v
'
DESIGNER/ENGINEER: _ of Applicable
MORTGAGE COMPANY:! _ of Applicable
Name:
Name: I
Address:
Address: I
City: State:
Zip: Phone:
City: I State:
Zip: Phone:I
I
FEE SIMPLE TITLE HOLDER: _ of Applicable
BONDING COMPANY: I _ of Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
I
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 lthat 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 Amendmi nts.
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 alnother 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 recordednand posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lenderor an attorney before
commencing work or recording vour Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/LicenIIse Holder
STATE OF FLORIDA �� STATE OF COUNTY OFORIDA
COUNTY •F L
The for oing instrument was acknowledged before me
this day of �C A.JQ P 20 L° by
G e.S
(N,iu.ne of person acknowledging)
(Signa Public- State of Florida )
Personall ,i,>'ft?vVn AI`6R4mrbfdbffd Iden
Ty�p�Ofr en^,i ycatiohowddW6u- State of Florida
).F Commission #
°' Pnv Comm. Expires M 2781!
res ay 0
Commission No.. �}
r;an�nai Notar Assr
Revised 07/15/2014
The 1p1going instr ent was i cknowledg d before me
thisday of 20% by
(Name of person
ally Known
Commission No.
ANGELA M :PUFF
of Florida
ommission # FF 234730
Bonded ljg,VR4,National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
I
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW i
REVIEW
REVIEW
DATE
COMPLETE
INITIALS