HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ff
Date: Permit Number:
3
awl's_
Building Permit App ication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED_111I�PR \(EMf'NT LQCAT]QN.F_ -
Address: 5824 Summerfield Ct.
Legal Description: The Grove Condominium-Section One-Unti 49E (OR 4)98-2007)
Property Tax ID#: 3410-507-0195-000-7 Lot No,
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE�CRIP-T 0E WORK
:.
replace 2 windows size for size - NOA 17-0411.06
- � t
Additional work to be Dertormed under this permit—check{ a apply:
❑HVAC Gas Tank Gas Piping n Shutters Q Windows/Doors
❑Electric ❑ Plumbing Sprinklers El Generator 1:1 Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3257 Utilities: Sewer Septic Building Height:
xOWNER/LESSEE ::_ 20CONT ACTOR r r
r
Y 1.
Name Anthony Byrne Name: Raquel Swanner
Address:5824 Summerfield Ct. Company: The Home Depot
City: Fort;Pierce State:FL Address: 6500 NW 12TH Ave.Suite 110
Zip Code': 34982 Fax: City: For:Lauderdale State:FL
Phone No. Zip Code -33309 Fax:
! E-Mail: Phone N (754)224-2010
Fill in fee simple Title Holder on next page (if different E-Mail: 1 nathon.thomas@expeditepermit.com
from the Owner listed above) State or County License: CGC1514813
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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i
SUPPLEMENTAL C NSTRUCTIDN-LIEN LAUV 1NF4RMATI N
DESIGNER/ENGINEER: . _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 1 Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDIN13 COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 authod e thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaw or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review you 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 oncurrency 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 mut be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencin work or recordin op-.Noticp�Commencement.
Signature of OWn/ef/AgeRff`Lessee Signature of Contractor/License Holder
STATE O FLORIDA STATE O FLORIDA
COUNMOF 54 t1414-t- COUNTY OF Sf zL -C C
The forgoing instrument was acknowledged before The forgoi g instrument was acknowledged before me
me this air day of Q 20 Irby this'2l d y of /'V1 ac/ 20_11;`by
(Name of person acknowledging) (Name of person acknowledging)
�57
Si nature of Nota Public-State of Florida
r (Signature of Notary Public-State of Florida) ( �g Notary )
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Id ntification Produced
Commissidn No. (Seal) Commission No. (Seal)
` VPV••y �Y Pjj•t�
`•':ne TIMOTHY R.O'MALLEY r`na•. TIMOTHY R.O'MALLEY
MY COMMISSION#GG 117135 . : MY COMMISSION#GG 117135
Revised 07/15/2014 - EXPIRES:August 7,2021 �° EXPIRES:August 7,2021
(I �•.o "`O�'P Bonded Thru Notary Public Underwriters "%q�,;:q� Bonded Thru Win Public Underwriters
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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