HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �(� ) Permit Number:,Sol
RECEIVED
Building Permit Application
FEB 16 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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: 640 Malayan Court, Fort Pierce, FL 34982
Legal Description: PALM GROVE S/D BLK C LOT 15 (0.13 AC) (OR 3858-2723-, 3878-1829)
Property Tax ID#: 3410-503-0083-000-7 Lot No. 15
Site Plan Name: Palm Grove Block No. C
Project Name: Palm Grove
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace exterior windows Simonton Amcraft Double hung insulated glass windows vinyl sashes
Non irndpCA4*) exiSF-i�,Ct 5kat+er'S, a l l u Pe11 1•1'J5 - '�J a); f1JDu)S
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all t t appy:
HVAC ❑Gas Tank F]Gas Piping In Shutters Z Windows/Doors
Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor: 1450
Cost of Construction: $ Q n Utilities: Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Linda Villipart Name:
Address:640 Malayan Court Company:
City: Fort Pierce State:FL Address:
Zip Code: 34982 Fax: City: State:
Phone No.772-828-0832 Zip Code: Fax:
E-Mail:Ivillipart@aol.com Phone No.
Fill in fee simple Title Holder on next page ( if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:Linda Vill+part Name:
Address:640 Malayan Court,Fort Pierce,FL 34982 Address: 640 Malayan Court
City: FortPierce State: FL City: State:
Zip: 34982 Phone 772-828-0832 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 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.,ANotice 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 recordi our Notice of Commencement.
nat ofner/Lessee/Contractor as ent fA-0"wner Signature of Contractor/License Holder
STATE OF F ORIDA STATE OF FLORIDA
COUNTY O � ex , COUNTY OF
The torgoing instr as acknowledge before me The forgoing instrument was acknowledged before me
this day of ' 20by this day of 20_ by
Name"ol person maki g statementName of person making statement
Personally Known OR Produced Identification ✓/ Personally Known OR Produced Identification
Type of Identifica 'on Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Commission No. " rP"''. KAREN Commission No. (Seal)
�= Commission # FF 115637
+.
oP; My Commission Expires
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17