HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `a
Date: 3`�� Permit Number: 1 DO3�'d5,�
RECEIVED
Building Permit Application MAR 1 9 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: 2355 DYER ROAD PORT ST LUCIE, FL 34952
Legal Description: ST LUCIE GARDENS 25 36 40 BLK 2 S 165 FT OF N 330 FT OF LOT 9-LESS E 330 FT-(1.37 AC)(MAP 34/25N)(OR 1757-72)
Property Tax ID#: 3414-501-1409-300-5 Lot No.9
Site Plan Name: Block No. 2
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF 10 WINDOWS (IMPACT)
CONSTRUCTION INFORMATION:
Additional work to b rtormed under this permit—check a apply:
HVAC Gas Tank Gas Piping 1i Shutters Windows/Doors
❑ a
11 Electric ❑ Plumbing a Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 23,300.00 Utilities:cn Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name DOUGLAS/BIANCA DIJOY Name: ALPHONSE CAMPANELLI
Address:2355 DYER ROAD Company: STORM TIGHT WINDOWS INC
City: PORT ST LUCIE State:FL Address: 500 SW 12TH AVE
Zip Code: 34952 Fax: City: DEERFIELD BEACH State:FL
Phone No.772-834-9075 Zip Code: 33442 Fax:
E-Mail: Phone No. 561-420-0271
Fill in fee simple Title Holder on next page(if different E-Mail: NMALLARD@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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 yo ' Ind to obtain financing, consult with lender or an attorney before
commencing wo k or recordin your Notice of Commencement.
1V';-z
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Signature of Owner/Lessee/Con ctor as A nt for Owner Signature of Contractor/LiceSTATE OF STATE OF
nse Holder
COUNTY OF FLORIDA :BP"_M COUNTY OF GRIDA T
l�J�y�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this+5 day of�n 4p C �A 20�6 by this_6_day ofapp r O 20 1A by
I. oNa Chip UU I i
Name of person making statementName of person making statement
Personally Known OR Produced Identification V/ Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced F D, Produced
/ A WWI" J VAU lPillmolhA 0�
(Signat e o�r tary c- a e (Signatu
Notary Public State of Florida �Or""w Notary Public State of Florida
Commis ' Nicole R L Mallard 1,4,,Seal) Commis r3, F• Nicole R L Mallard 1 /Sea
aw Ypres 02/11/2022 ora Expirh4Lres 02/11/2022 84861
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17