HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
F L O R 1 D j% -'
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
1306 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR: Window/door Id
PROPOSED IMPROVEMENT LOCATION:
Address: 1107 Nettles Blvd.
Legal Description:
Property Tax ID #: 450250112940005 Lot No. 1107
Site Plan Name: Block No. 2
Project Name:
Setbacks Front Back: Right Side: Left Side:
Removal of entry doors and replace with impact fiberglass impact rated doors. This includes two
impact side lights at the main entrance with standard 86x 80 out swing door. Second entrance is 74x
80 french door style with impact glass and fiberglass impact rated doors, k10
-tswing.
Corocrt-�-C $1Oc/L ww
�u. Pr<+s, �-rti•�1.`d� �v!K -�,rn.,,..,..,oJ ) s)
MUUMIU11d1 WUM Lo oe ertormea unser tnis permit– check all apply: -
0HVAC Gas Tank []Gas Piping _ Shutters ✓� Windows/Doors
UElectric 0 Plumbing Sprinklers Generator Li Roof Roof pitch
Total Sq. Ft of Construction: S. Ft. of First Floor:
Cost of Construction: $ 6700.00
Utilities Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
NameKenteth Roderman
Name: James Hamilton
Address:5741 Lois Ln.
Company: Your Brother's Keeper LLC
City: Plano Stater_
Address: 600 NE Ocean Blvd.
Zip Code: 75024 Fax:
City: Stuart State: FI
Phone No. 972-975-8298
Zip Code: 34996 Fax:
E -Mail: ken.roderman@gmail.com
Phone No. 772-214-8135
rr i in fee sim ie —Mie voider on ntxi pagelif dif ereni
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from the owner listed above)
State or County License: CRC1331087
•. w—W WE 1 N %P&.FWV Y1 191v1c, 0 nLbv#%L#&W 1WLeLF= u1 Lu mmerivannenz is requires.
- - - , _, 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 be f re
commencingwork or recordingour Notice of Commencement.
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Signpure of Owner/ Le see/Contractor as Agen or ®wl> Sig ture of Co r/License Holder Z" e Z9
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II COUNTY OF a COUNTY OF - a i I
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The forgoing instr me was acknowledge efo W a The f r Ding instru en was acknowledge efor me
th' day of 20 by a thl day of 20 by -
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a m �'
Na arson making statementName of person making statement
P sonally o OR Produced Identific - Per Ily Known OR Produced Identificati
pe of Identifica Type of Identification
Produced Produced
(Signature of tart' Public- State of Florida) (Signature ofVary ary Public- State of Florida)
I Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 9/2/17
SU�PPLEMEAL CON5TRUCTtQN LIEN LAW INFORMATION•
DESIGNER/ENGINEER; _ Not Applicable
.T
MORTGAGE COMPANY: _ Not Applicable
Name: Kenteu, Radem,an Name: James Hamilton
Address: 1107 Nettbs Blvd. Address: 5741 LOIS Ln.
City: Piano State: City: start State:
zip: Phone Zip: Phone:
fff SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Appficable
Name: Name:
Address: soo NE ocean Blvd. Address:
City: city:
Zip: Phone:
Zip: Phone: