HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED so
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Date: (��'2(� Permit Number: �/✓
- RECEIVED
Building Permit Application JUN 0 5 2018
Planning and Development Services ST. Lucie County, 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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 4840 Grovers Road
Legal Description: 13 34 39 S 147 FT OF E 105 FT OFS 299.54 FT OF E 200 FT OF W"OFT OF N 928.60 FT OF SW 1/4 OF NE 1/4(0.35 AC)(OR 3778-1697)
Property Tax ID#: 1313-132-0005-010-8 Lot No.
Site Plan Name: Block No.
Project Name: Brittiny/Charles Batz
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacement of 9 Windows (Impact)
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit—check a appy:
HVAC El Gas Tank []Gas Piping _Shutters ✓�Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 18900.00 Utilities:cn Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameBrittiny/Charles Batz Name: -Alphonse Campanelli
Address:4840 Grovers Road Company: Storm Tight Windows Inc
City: Ft. Pierce State:FL Address: 500 SW 12th Avenue
Zip Code: 34951 Fax: City: Deerfield Beach State:FL
Phone No.561-632-0850 Zip Code: 33442 Fax:
E-Mail:balbertson24@gmail.com Phone No. 561-420-0271
Fill in fee simple Title Holder on next page( if different E-Mail: kramirez@stormtightwindows.com
from the Owner listed above) State or County License: CRC-046091
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
N a1 m e:Brlttiny/Charles Batz N a me:.Alphonse Cam �i
panel
Add ress:4840 Grovers Road Address: 4840 Grovers Road
City: Ft.Pierce State: City: Deerfield Beach State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:500 sw 12th Avenue 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. 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
comme work or recording our Notice of Commencement.
Sig ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDAl STATE OF FLORI A_
COUNTY OF _`7� C� c__lC,�cACOUNTY OF l Lek
The for oing instrument was acknowledge before me The fo�ing instrument was acknowledp�,d.before me
this r day of Z( - 20�by this_�day of 12,20_ by
Name of person making statement kame of person aking stat ment
Personally Known OR Produced Identification Personally Known person
Produced Identification
Type of Identi�cation Type of Identification
Produced Produced
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(Si nature Notary Publi t.FLe Signatur f Notary Public-State of Florida)
.►M'�� Notary Public State of Flontla //�//� U
J GG (7 ( �lJ�� �`�r al)Notary Public State F ntla
Commission No. - e(fsefaljDubten ommission No. Jennifer Dublen
• My Commission GG 179700 M Commission GG 7 00
'kf�i nol Expires 01 28/2022 Y
ry v��M+ •'?o�'no'
Expires 01 128/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17