HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1110
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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: UUi rid 0c, ,/,0C
PROPOSE DyIIyIPRQVE'MENT LOCATION .
Address: 21 LAKE VISTA TRL#106
Legal Description: VISTA ST LUCIE BLDG 21 UNIT 106 (OR 2545-683)
Property Tax ID#: 3400-500-0286-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF V1/ORK r ;
.I
REPLACE 5 WINDOWS WITH 3 EXISTING ACCORDION SHUTTERS AND INSTALL 2 NEW
ACCORDION SHUTTERS
CONSTRUCTfON INF0RMAT_1'0N ,
Additional work to be nertormed under t —checkispermit a appy:
HVAC Gas Tank F]Gas Piping Shutters Z Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SIn
of First Floor:
Cost of Construction:$ C2 'yez / Utilities: Sewer Septic Building Height:
OWNER%LESS.EE "CONTRACTOR'
NameBRENDA KIBBE Name: MATTHEW MARKS
Address:21 LAKE VISTA TRL#106 Company: EAST COAST ALUMINUM,
City: PSL State:FL Address: 913 EDWARDS RD.
Zip Code: 34952 Fax: City: FORT PIERCE State:FL
Phone No.508-738-8379 Zip Code: FORT PIERCE Fax: 772-464-7603
E-Mail: Phone No. 772-464-7600
Fill in fee simple Title Holder on next page(if different E-Mail: ECAPINC@HOT MAIL.COM
from the Owner listed above) State or County License: 24526
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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i'
SUPPLEMENTAL CONSTRUCTION LIEN LAW fN'FORMATIOIV $ � .
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:
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 thepermit 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S'T- Lucie COUNTY OF 5-►. Luc(
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisWdayof OCT6599:- 20Z by this-Mladayof ocr-mg-a— 20_(2 by
/�J.ATT/aE�► /yARKt Mi9TTFfE1.► MARt�cS
Name of personJaking statement Name of person making statement
Personally Known V .OR Produced Identification Personally Known ✓OR Produced Identification
Type of Identification Type of Identification
Produced Produced
��✓Zdi+s�.�In Zoe-•^-- �s,..c,�/yI. �
(Signature of Notary Pu - f NALD M.401-MAN (Signature of Notary Public- at�� {''P, jda) -DONALD M.'NOLMA
auiu,,
o��r s�a, Notary public'=State of c 8
,�?r . No�%Jrblic-State of Florida
Commission No. . _ ommission No. �•.Se& mission 4E FF 913 4
•: omm ssion N FF 913240
V.
M Comm.Expires Sep 20,201 +,��� ;c• MY Comm.Expire:Sep 2 19
Y emiedthrough Natlonal Not sn.
�%�4 �t„` Rn 11 thou Nadi”Notary
REVIEWS FRONT. ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17