HomeMy WebLinkAboutBuilding Permit Application " f
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04 OCT 17 Permit Number: V:r
=s==__- J _T'_= W:- RECEIVED OCT 0 9 2011
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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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT.LOCATION:
Address: 219 OLSON AVE, FT PIERCE,FL
Legal Description: OLSONS S/D LOT 14 AND E 1/2 LOT 16(OR 4016-1754)
Property Tax ID#: 1433-502-0014-000-5 Lot No.14/16
Site Plan Name: 219 OLSON Block No.
Project Name: 219 OLSON
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE 17 WINDOWS WITH EXISTING OPENING PROTECTION. NO OPENING
MODIFICATION TO STRUCTURE. SII ply --4—M J2A
CONSTRUCTION INFORIVIATION:
ACICII-lona work to be nertormed under this permit—check all t=appy:
HVAC Gas Tank ❑Gas Piping _Shutters ✓Q Windows/Doors
11 Electric 0 Plumbing OSprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2,400.00 Utilities:ll Sewer 0 Septic Building Height:
OWNER/LESSEE: - CONTRACTOR:
NameTD ENTERPRISES FP LLC Name: JON LEVASSEUR
Address:2361 COOLIDGE RDCompany: EDEN SCREEN&CONSTRUCTION CO.,INC
City: FT PIERCE State:FL Address: 1997 SE ESTERBROOK ST
Zip Code: 34945 Fax: City: PORT ST LUCIE State:FL
Phone No.772-486-4992 Zip Code: 34983 Fax:
E-Mail:BDGRADING@ATT.NET Phone No. 772-216-6171
Fill in fee simple Title Holder on next page(if different E-Mail: EDEN68@AOL.COM
from the Owner listed above) State or County License: CBC 059494
If value of construction is$2500 or more;a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION-
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Nam Q Name ssEaR-
Address: Address:
City: R 04C= State: City: E State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Addres . Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 work or recording our Notice of Commencement.
Si ure of Owner/Lessee/Contractor as Agent for Owner sigi4ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5�. �,Uc`� COUNTY OF '�,A , L J '- %_e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day ofd 4z 1' 20,E by this °` day of d�� 201 by
SSA�' Lsm �perso�'�-�`�
Name of n making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced Irl. ) L
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(Signature of Notary Pub ic-State of Florida-)- 9„� ;w (Signature of No :U fj StWLp@V1FIkV.ld )0G or�n23 t:
yr •a`: EXPIRES:December 16,2020
DE NA 1ARIE GIVENS F0F"0P' n d Thru Nota P
Commission No.�� :'' 3 ;ry, ry barite;
tityG � ]ON 02202,. Commission No. It��lj:,
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:a. EXPIRES:December 16,2020
Bonded Thru Notary Public unrienvmrs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE _T
COMPLETED
Rev.8/2/17
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