HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p
Date: Permit Number: 0
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Building Permit Application JAN 2 2
Planning and Development Services 2��8
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:
PROPOSED IMPROVEMENT-LOCATION:
Address: 7502 Ft.Walton Ave Fort Pierce,FI 34951
Legal Description: LAKEWOOD PARK-UNIT 6-BILK 67-A LOTS 8 AND 9(MAP 13/02S)(OR 3431-1640)
Property Tax ID#: 1301-606-0207-000-8 Lot No.8&9
Site Plan Name: Block No. 67
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REplace skylight with Impact Rated Skylighty FI15592-R2
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—ch—e— a appy:
HVAC 0 Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 0 Generator Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 1448 S . Ft.of First Floor:
Cost of Construction:$ 951.00 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE; CONTRACTOR:
Name Julisa Luna Name: dames Cody Thomas
Address-7502 Ft.Walton Ave Company: Florida Retrofits, Inc
City: Fort Pierce State:Fl Address: 2840 Kirby Circle#3
Zip Code: 32951 Fax: City: Palm Bay State:Fl
Phone No.772-801-5685 Zip Code: 32905 Fax:
E-Mail: Phone No. 877-659-8354
Fill in fee simple Title Holder on next page(if different E-Mail: info@floridaretrofits.com
from the Owner listed above) State or County License: CBC1259135/CCC1330830
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: _Not Applicable
Name:Jullsa Lune Name: James Cody Thomas
Ad d ress:7502 Fort Walton Ave Fort Plerce,Fl 34951 Address: 7502 Fort Walton Ave
City: Ft Pierce State: City: Palm Bay State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add ress:2840 Kirby Circle#3 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 w0 or recording our Notice of Commencement.
Signature of ner/Lessee/Contractor as Agent for Owner Signature Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f;�'r'c�J COUNTY OF �I c>.�+r ✓�
The forgoing ins5mment was acknowledged before me The forgoing instNment was acknowledged before me
thiiss'1'7 day of 20•L�by this 17 day of/J 5 20/� by
Name of per on making statement Narar on making statement
°= Personally KnoWPt� OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
22�a�l 6�__> —
(Signature of o o C.4�tcS-�S �t ���S(�r �KENSHIP (Signature of Not ry;Plfb iG,.;Stba Ar+9A kANKENSHIP
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Commission Ni ." " MY COMMISSI F153833 I" MY COMMIS N FF153833
Commission No. _.�` �•Q Opal
EXPIRES August 24, 2018 oFF�o PIKES Ail us24,2018
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(407)398-0150 FlorldallotaryService.com (407)39a-0153 FlorldallotaryService.com
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED T_
Rev.8/2/17