HomeMy WebLinkAboutBuilding Permit Application ¢.LL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� I
Date: Permit Number: 0®� `N Up
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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 _
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PERMIT APPLICATION FOR:, -� l ►�+P�4C�7 I�J�,,,�
PRQPaSED 11111PROUEMENT LaCATION
Address: 213 BEACH AVE,PORT SAINT LUCIE,FL 34952
Legal Description:
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Property Tax ID#:3419-501-0050-000-8 Lot No.
Site Plan Name: Block No.
Project Name:TIFFANY KEARNS ;I
Setbacks Front G Back: L4 Right Side: Left Slde:ll
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DAILED DESCRIPTION,t�FWORK
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(Replacement ofwindows Odoors
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CtNSTRUCTIC?N INFORiIATIQ(V� = ' t xf 3
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itiona work to be nortormed under is permit—check all tha apply:
El HVA Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
ElElectric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S .Ft.of First Floor.!
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Cost of Construction:$ 8979 Utilities: Sewer Els6ptic Building Height:
OVtfNEtR/LESSEECUNTR£ACT�OR �I
Name TIFFANY KEARNS Name:Alphonse P.Campanelli
213 BEACH AVE
Address: Company:Storm Tight Windows,Inc.
City: PORT SAINT LUCIE State: FL Address:500 SW 12th ave
Zip Code: 34952 Fax: City:Deerfield Beach State.-FL
Phone No. (772)233-6897 Zip Code: 33441 1! Fax:561-292-3562
E-Mail: Phone No. 561-53;6-4387
Fill in fee simple Title Holder on next page( if different E-Mail: bbatista(a,stormtightwindows.com
from the Owner listed above) State or County License:CRC046091
If value of construction is$2500 or more.a RECORDED Notice of Commencement is required.
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SUPPLEMEN'TALCQNSTR.UCTI+�N LIEN LAiN INF �RMATIQN �h_ .",4F t
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:
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II certify that no work or installation has commenced prior to the issuance of a permit. ii
St.Lucie County makes no representation that is granting a permit will authorize the per holder 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.
he 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 an 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.
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Signatu e f w e Agent/Lessee Si nature of Contractor/License Hol er
STATE OF FLORIDA STATE OF FL O DA
COUNTY OF• �m1ti 1'4xJ� COUNTY OF Q
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this A day of 20 18 by this LO day of JCW ,20_W by
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A MVA2A PoSL!f
,1JNJne of pe acknow led ing} {Name of person acknowledging}
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(Sigriature of NotaYy P blit-State of Florida} {Signature of Notary, P6-b"- tate of Florida}
Personally Known OR Produced Identification ✓ Personally Knowny OR Produced Identification
Type of Identification Produced G L Type of Identifications Produced
Nor�p blit State of.Florida
Commission No.07 1 M ey Commission No. CIC�1 Ib 9ys7
+� � My Commission GG 169457 I: Notary Public State of. rida
'? Ex fres 12/19/2021 Mara Posey
57
.I a M1 Expires 12/19/2021
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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