HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,}
Date: 1 �� Permit Number: 11�1���d`�
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CRCEIVED
Building Permit Applicatio0 5 2018Planning and Development Services unty, Permitting
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: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 1401 MALLARD CT FORT PIERCE, FL 34982
Legal Description: NORTH FORK ESTATES S/D LOT 27 (0.50 AC) (OR 1784-2914)
Property Tax ID#: 3409-503-0030-000-7 Lot No. 2-7
Site Plan Name: Block No.
Project Name:
Setbacks Front .r Back: �Right Side: r Left Side:
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DETAILED DESCRIPTION OF WORK: , ll
WINDOW REPLACEMENT L!/ ljc��A&-r beo'dLK /Jaw/ /_j
CONSTRUCTION INFORMATION:
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Additionalworkto e er orme under this permit—check a appy:
DHVAC Gas Tank Gas Piping _Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers F]Generator Roof Roof pitch
Total Sq. Ft of Constructio SFt. of First Floor:
Cost of Construction: $ , Utilities: _Sewer 17 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name DEBRA CYMBAL Name: GARY WHIGHAM
Address: 1401 MALLARD CT Company: SOUTH FLORIDA ALUMINUM PRODUCTS
City: FORT PIERCE State:FL Address: 4807 SO US HWY 1
Zip Code: 34982 Fax: City: FORT PIERCE State: FL
Phone No.772-466-3844 Zip Code: 34982 Fax: 772-466-1074
E-Mail: Phone No. 772-466-0913
Fill in fee simple Title Holder on next page ( if different E-Mail: SFAPBOOKS@SOFLALUM.COM
from the Owner listed above) State or County License: CRC1330712
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:1-t) C G S A- TL) C 0--Q- C Name:
Address: V Address:
City: I State: L- 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 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
WARNI ,TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improv mgnts to your property,A Notice of Commencement must be recorded and posted on the jobsite
befor the first in pec ion. If y I end to obtain financing, consult • lender or an attorney before
com enci o rec rdin r Notice of Commencement,---
.
Sign ure 6f Ow er/Le e /Contractor as Agent for Owner r or/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF 5 L L) COUNTY OF f5 7-. L
The forgokg instru�p�en was acknowledgeq bRfore me The for instr n was acknowledged Wo re me
thia7—day of t`� f V4 f`1 ,20J this' day of ��, 20_t!by
Ci r__q n-1 h. ' l c UPJ h L �o/ h u vv-�'
Name of person making statement Name of person making statement
Personally Known ✓ OR Produced Identification Personally Known L,- OR Produced Identification
Type of Identification Type of Identification
Produced Produced
6,1 -
(Signature/if rrotary Public-State of Florida) (Signature o otar Public-State of Florida
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Co rr} s`' ? ,ttl0.MARY ANN MATO ��e I) Commis cd'ri �r MARY ANN MATO//i��dTallItt
MY COMMISSION 4 FF953138 N u FF953ei�8
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EXPIRES January 24.2020 ?a'r EXPIRES January 2d 2020
,40/,(!IP WWI F1*rMaNn:a' Sarvu:u;.Orc
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17