HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'p 1� Permit Number: 116 9-ln 53
Building Permit Application RECEIVED
Planning and Development Services JUN 18 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 T. kwtic.Cbwficy, Permlttiflg
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 5201 Fort Pierce Blvd
Legal Description: Lakewood Park Unit 3 BILK 21 Lot 15(MAP 13/11S)(OR 4029-2272)
Property Tax ID#: 1301-603-0132-000-2 Lot No.15
Site Plan Name: Block No. 21
Project Name: Fogg
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Removing all doors & windows and Replacing with new windows & doors
CONSTRUCTION INFORMATION:
Additional work toa nerformed under this permit—check a appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: 1640 S Ft. of First Floor: 1640
Cost of Construction: $ 8000.00 Utilities. Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RWPT US 1,Inc.%Neil Noden Name: Danielle Beggs
Address:PO Box 448 Company: Alliance Group
City: Greenlawn State:NY Address: 532 NW Mercantile PL#113
Zip Code: 11740 Fax: City: Port St. Lucie State:FL
Phone No. Zip Code: 34986 Fax: 772-492-8008
E-Mail: Phone No. 772-492-8006
Fill in fee simple Title Holder on next page(if different E-Mail: wanda@alliancegroupllc.com
from the Owner listed above) State or County License: CGC1520974
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: 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 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
commencing work or recording our Notice of Commencement.
� 1 1
Signature of OwnerL ssee/Contractor as Agent for Owner Signa ure o Contr Gt r/License Holder
STATE OF FLORIDA STATE OF FLORID /
COUNTY OF COUNTY OF
The instr t acknowledg �efore me The f instr n s acknowledg efore me
this day of 20� by this day ofd 20 by
la&Me LxE
Name of pers n making staqnent Name of pers!?h making statement
n
Personally KnowOR Produced Identification Personally Known (V OR Produced Identification
Type of Identification Type of Identification
Pro uce�d Produced
laux� A'd�'—w
(Signature o .N to u 11' - (Sig azure of
Notary Pub� sq�s of Flotkla Notary Public State of Florida
Commission No. Karolyn PIT= Commission No. Karolyn H Leq�G
My Commission GG 224008 Commission GG 224008
aw Expires 08/03/2022 a� Expires 08/03/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17