HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE A CEPTED f (�
Date: Pe mit Number:
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Building Permit Application
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 x
PERMIT APPLICATION FOR: Window/door
PROPOSEUIM'PROVEMENT LOCATION_::
Address: 10701 S Ocean DR Lot 924 Jensen Beach, FL 34957-7603
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 924 (OR 096-1139) - -
Sec/Town/Range: 11/37S/41E
Property Tax ID#: 4511-510-0124-000-2 Lot No.924
Site Plan Name: Block No.
Project Name: Denis C Lebel/Tammy M Lebel
Setbacks Front Back: Right Side: Left Side:
DETAILfD,DES.CRIPTION'OFjWORK:'
REPLACEMENT OF 12 WINDOWS (IMPACT)
CONSTRUCTION'INFORM 4TfON
Additional work toe e orme under this permit—check` a a ply:
HVAC ' rI Gas Tank ❑Gas Piping _S utters Q Windows/Doors
Electric 0 Plumbing Sprinklers F G nerator 0 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of irst Floor:
Cost of Construction:$ 17934.00 Utilities:11 Se er E]Septic Building Height:
OWNER/LESSEE:.. -CONTRACTOR: :=
Name Denis C Lebel/Tammy M bel Name: Alphonse Campanelli
Address:10701 S OCEAN DR 9a Compa y: STORM TIGHT WINDOWS
City: JENSEN BEACH State:FL Address: 500 SW 12TH AVENUE
Zip Code: 34957 Fax: City: D ERFIELD BEACH State:FL
Phone No.(207)576-9365 Zip Cod : 33442 Fax: 754-227-7891
E-Mail:denis@shermarnolds.com Phone No. 954-320-7554
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: CRC046091
If value of construction is$2500 or more,a RECORDED Notice of Commenc ment is required.
SU'PPLEMENTAL,CONSTR-TAC LIEN LAWU INFORMATI N `
.
DESIGNER/ENGINEER: _Not Applicable MORTGA E COMPANY: Not Applicable�I
N a m e:Denis C Lebel/Tammy M Lebel Name:Alpho se Campanelli /utp'�
Address:10701 S Ocean DR Lot 924 Jensen Beach,FL 34957-7603 Address: 107018 OCEAN D T 24
City: JENSEN BEACH State: City: DEERFI LD BEACH State:
Zip: Phone Zip: I I Pho
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 obtai 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 authori a the permit 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 th t I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Luci 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 ccessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commen ement may result in your paying twice for
improvements to your property.A Notice of Commencement m st be recorded and posted on the jobsite
before the fitst inspection. If you int"d to obtain financing, con ult with lender or an attorney before
commencing work or recw-dipg yoAflotice of Commencement.
f
Signature of Owner/Les /Contractor as Agent for Owner Signature Contractor/License older
STATE OF FLORIp���� J STATE F FLOR� C`�
COUNTY OF ``ii J COLIN OF c.t71',LC
The f oing instr me w cknowledged before me The fo o ng instrument was acknowledged before me
this day of 20 W',by this ay of 20Li� by
Name of rson makifig statement ame of person akin statement
Personally Known OR Produced Identification V/ Personal, Known_�OR Produced Identification
Type of Identification Type of I entification
Produced ��( . Produce
F
ignature otary Public-State o F o i Tna of ota Public-State of FIrr" �N of Public State of Floridr a Notary Public Sta Florida
Commission No.G CL7 ' �'Jre� ferDublen ion No. 7�7 _° Jennifer Dubre
My Commission GG 179700 a My Commission G 79700
or r�° Exp,res 01 12812022 �jor °' Expires 01128/20 2
REVIEWS: FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17