HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: Permit Number:1217
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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 X Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 9319 Scarborough Lane Port St. Lucie, FL 34986
Legal Description: PODS 12 AND 13 PUD 1 AT THE RESERVE SCARBBOROUGH ESTATES (PB 45-13) LOT 19
(OR 4127-1401)
Property Tax IID#: 3322-507-0024-000-8 Lot No. 19
Site Plan Name: Block No.
Project Name:
Setbacks Front Back-. Right Side: Left Side:
FDETAILED.DESCRIPTION OF WORK:
WINDOW REPLACEMENT �� (,i/� JS /.J O 72�? `
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
11HVAC E]Gas Tank E]Gas Piping Shutters �indows/Doors
❑Electric ❑ Plumbing Sprinklers 11 Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
a�
Cost of Construction:$ /�, Utilities: _Sewer 11 Septic Building Height:
,OWNER/LESSEE:. CONTRACTOR:.
Name Robert S Ascherfeld Name: Gary Whigham
Address:27 W Harbour Isle W Dr. Ph 1 Company: South Florida Aluminum Products
City: Ft. Pierce State:FL Address: 4807 So. US Hwy 1
Zip Code: 34949 Fax: City: Ft. Pierce State:FL
I Phone No. Zip Code: 34982 Fax: 772-466-1074
E-Mail: Phone No. 772-466-0913
Fill in fee simple Title Holder on next page(if different E-Mail: sfapbooks@soflalum.com
from the Owner listed above) State or County License: CRC1330712
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City: .
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your prop ty. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspectio ou intend to obtain financing, consult with lender or an attor ey before
commen n wyork or r or, our Notice of Commencement. ten/
4i �ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF.$t- 4-ye—c�:e COUNTY OF
The forgoing instr ent as knowledged before me The for oing instrument as acknowledged before me
this 1"qday of 20�by this=day of 201�by
Name of person aking statement Name of persorymaking statement
Personally Known t m OR Produced Identification Personally Known L/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of bAry Public-State of Florida) (Signature f Notary Public-State of Florida)
Commis I Commissi n,- '.1' AA p
�pRY Iy - MARY ANN Pv ATONTI 1'ANN MAT NT
MY COMMISSION 4 FF95318 q T, MY COMMISSION t{FF953138
•'�p� ` Jfi J 1331:.(;,.b3Flur rLiNa:rv5rry r.r..r1
REVIE /13i'" ` b nd"" UPERVISOR PLANS VE ANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17