HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TOB ACCEPTED
Date: July 11, 2018 ermit Number: �O[.�
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j Building Permit Apr lication
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
RROPO_S`ED IIVIP.ROVEM.ENT LOCATION r
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Address: 1°l3lp p►nl � ie�C.P 3��� .
LI egal Description: Orange Blossom Estates First ADDN BLK 1 LOT 18-Less N 5 FT OFE 67.58 FT and LESS N 7.3 FT
OF W 45 FT-(0.24 AC) (OR3352-1152)
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Property Tax ID#: "-'c� Lot No.
Site Plan Name: Block No.
Project Name: JONES-853
Setbacks Front Back: Right Side: Left Side:
,DETA'LED DES°CRIPT ION§OF WORK $ zy
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Re�'.w. 3 biIw6os 151 x .-fir 5,�2 1mpad-
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CONSTRUCThON INFORMATION � �yE
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Additionalwork toe nertormed under this permit check all ap y:
HVAC Gas Tank []Gas Piping _Sh itters Windows/Doors
11 Electric 0 Plumbing O Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of F rst Floor:
Cost of Construction:$ 2,540.00 Utilities: Sew r Septic Building Height:
I
DOWNER/LESSEE CONTR CTOR ;
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Name E\Iar)130fr-S Name: QrlL CoUlt"
Address: 9310 �l-1V�'ntn� Company Window World of West Palm Beach
City: PicyIe_6� v Staten Address: S60 N ���,o6_& Maw
Zip Code: 3y�0a Fax: City:. G State:FL
(hone No. Zip Code: 3409 Fax: 561-684-2050
E-Mail: Phone No 561-684-2040
w st almbeach windowworld.com
FIill in fee simple Title Holder on next page(if different E-Mail: P @
from the Owner listed above) State or C unty License: CBC1260052
If value of construction is$2500 or more,a RECORDED Notice of Commencem nt is required.
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Sl1PPlEMENTAL CONST,R'UCTION LIEN LAW INFORMAION k g
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE GE 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 autho ize thepermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,byla s 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. Lu ie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swim 'ng pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
,WARNING TO QWNER: our failure to Record a Notice of Commencement ma result in your paying twice for
improve meyy�it's to yo pro y.A 'of Commencement m st ec ded and post the jobsite
before t first ins ct' If meto obtain financing, co t wi lende r . attorn y before
commencing w o eco , 'nr Notice of Commencem
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i nature of 0 -Lessee/contractor as Agent for Owner Ignatur of Contractor/License Holder
1 STATE OF FL
COUNTY OF OR�Cv COUN OF STATE OF O (�l YY1 �GCC l
The for oing instrument was acknowledged before me The for ing instru e t was acknowledged before me
this_ ay of 4 u-!�:j 20 [';[by this day of -ZQV4 20181 by
MARK CO LINS
Name of person making statement Name of perso making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produce
(Signature of N a Publ -Sta (Signat a of Notary Public-Sta oFlorida
„�„
• Notar KARiN`�r11E .�`k;;y�Ge, CHEYENNE SHARP
Commission o. tj) yPubiic 5 Com fission No. °%°a. �,' Florida
.:'�,oaF�cfF°�' MYCommissio- te 9f ida -,,; A709 My coNotamm.eex�eees�Dec.te f17, 2019
�Pires Jai 1?
r�onded(h,vug/Harin 21 Commission Number FF 944967
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REVIEWS FRONT ZONING SUPERVISOR NS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17