HomeMy WebLinkAboutBUILDING PREMIT APPLICATIONALL 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
7300 Virginia Avenue, Fort Pierre FL 34987
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 709 ANITA STREET FT. PIERCE FL 34982
Legal Description:
Property Tax ID #:3403-332-0013-000-0 Lot No.
Site Plan Name: Block No.
Project Name: ELMER & JANICE SMITH
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
4
Replacement Windows (15)
CONSTRUCTION INFORMATION:
AciclitionalworKlOofejerlormedunder tispermit—check all appy:
HVAC Gas Tank ❑Gas Pipingn_ Shutters Windows/Doors
13 Electric El Plumbing []SprinklersOGenerator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ $ 21, too. Utilities:I]Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ELMER & JANICE SMITH
Name: Sam Ochstein
Address: 709 ANITA STREET
Company: Newsouth Window Solutions
City: FT. PIERCE State: FL
Address: 2526 Okeechobee Blvd.
City: West Palm Beach State: FL
Zip Code: 34982 Fax:
Phone No. 772-595-9752
Zip Code: 33409 Fax: 561-478-4100
E -Mail:
Phone No. 561-712-9000
Fill In fee simple Title Holder on next page ( if different
E -Mail: westpalmbeach(a)newsouthwindow.com
from the Owner listed above)
State or County License: CRC1330822
if value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:_
Zip:
Phone:
I certify that no work or installation has commenced prior to the Issuance of a permit.
St. Lucie County makes no repregentation that is granting a permit will authorize the permit holder to build the subject s�rItcture
which k in conflict with any applicable Home Owners Assoction rules, bylaws or and covenants that may restrict or pro ibitsuch
structure. Please consult with your Home Owners Association and review your deed for any restridions 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
,n iw nrinaa nrk nr rernrdine4our Notice of Commencement. _ /I
Signature of Owner/ Agent/ Lessee
STATE OF FLORIDA��
COUNTY OFA w`AL 122- 7
The fo!Foing instru ntwas acknowledged before me
this day of 20 J1 -by
l 2,V At
(Name of person acknowledging }
(Signature of Notary Public- State of Florida }
Personally Known OR Produced Identification X
Type of Identification ProducecL k
Commission No.y-gxcy �f: �
_�"tKIM AMSTON
Revised 07/15/2014
of Contrecror/License Holder
STATE OF FLORIDA `
COUNTY OF
The f�j6oing Instrygment was acknowledged before me
this _f� day of 20_4 by
(Name of person acknowledging)
A- 44Z,
(signature 6rNotary Pblic- State of Florida }
Personally Known _YOR
OR Produced Identification_
Type of Identification Produced
No." 1"W14 S`y�.",!k kMA. STONE
►!f! My COMMISSION 4 FF929006
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
COMPLETE
INITIALS