HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
J,[
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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
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Address: - (M70 �i P (Cic-9—
Legal Description:
Property Tax lD#-C
IJ— 1IN—rc i Lot No.
Site Plan Name:
L CV' '1C Block Block No.
Project Name: Wi 1,
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
J 1/t4a (G-61
_
CONSTRUCTION INFORMATION:
Additional work tobe D rformed under this permit — check all apply:
HVAC
U Gas Tank F]Gas Piping Shutters 2Windows/Doors
Electric F Plumbing RSprinklers Generator 0 Roof Roof pitch
Total Sq. Ft of Construction;
I
Cost of Construction: $
it
_�
S Ft
of First Floor:
Utilitiesll Sewer F]-
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name W I-, I I t OL"A � V44 Q K I A ill
Name: Michael O'Donnell
AcldrE rlf PLI-7111)jL,
Company: O'Donnell Impact Windows
City: ELi-+ �;+_ Lik6L. — State: - C��L
Zip Code: 'q TqStl/ Fax:
Phone No .
Address: 1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No. 772-408-0200
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: odonnellpermifting@gmail.com
State or County License: CRC1 331273
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: ` Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
N am e: Michael O'Donnell
Address:
Address:
City: State:
Zip: Phone
City: Stuart State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address: 1740 NW Federal Hwy
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 attornev before
-ommencing worts or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF A"/A, COUNTY OF_�)�
The for ink instr ent was ac nowledg efore me
this day of 20L by
r
I � �
Name of person ing statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signatur f Notary Public- State=af�1 �.
��qP
" p'`'� WYNN ALLEN
Commission No. �'tary PubOe4hate of Florida
•; om lisslon # FF 923070
•'� '',F OF F4.�•:�°� My Comm. Expires Sep 30, 2019
REVIEWS I COUONTER NT ( ROEVIEW NING S REVIEW
RECEIVED
DATE
COMPLETED
Rev. 8%Z/ 1 /
The fo rinstr ent was ack owledg efore me
this day of 20by 't
M I tl�ft � 1 )i (1
Name of personw1kimg statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signatof Notary Public- State of Florida) _.., ...,
l "; WYNN ALLEN
Commission No. ; J> 1_ 0;6dlotary M- State of Florida
=• t; Commission # FF 923070
My Comm. Expires Sep 30, 2019
PLANS VEGETATION SEATURTLE I MANGROVE
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