HomeMy WebLinkAboutBuilding Permit application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�
Date: Permit Number: �6 r lJW
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Building Permit Application ?Planning and Development Services ?CBuilding and Code Regulation Division Sr Luc2300 Virginia Avenue, Fort Pierce FL 34982 ��'�ri►11tEJnq
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: LAKEWOOD PARK-UNIT 06- BILK 68 LOT 19 (MAP 13/02S) (OR 3805-844)
Property Tax ID#: 1301-606-0249-000-4 Lot No. 19
Site Plan Name: Block No. 68
Project Name: ANGELA/DEBORAH DANIEL
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF 12 WINDOWS (IMPACT)
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check all h appy:
HVAC Gas Tank Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 21700.00 Utilities:Sewer[]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ANGELA/DEBORAH DANIEL Name: 19 C i4)M 1"i4 W Q
Address:7407 SALERNO ROAD Company: STORM TIGHT WINDOWS n '
City: Fort Pierce State: FIL Address: p v4 1 1: ? 1 2 w
C
w Z
Zip Code: 34951 Fax: City: Q E'[14 ;—' )( &C-b State,FL
Phone No.(772)293-1097 Zip Code: 434423-74003 Fax: 754-227-7891
E-Mail:SHORTBUSDRIVER1@GMAIL.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 Commencement is required.
i-AU PLEMENTAL CO -RU, ION= ,IEN 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 thepermit 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 before
cornmencing work or recording our Notice of Commencement.
gna ure of Owner/Lessee/C tractor s Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLOR
COUNTY OF F�1C6 COUNTY OF J �.�
a
Theing inst men was cknowledg efore me The r oing ins me t was acknowledg efore me
thAor oday of , 20�by this day o 20 Eby
�-�E cVD\x(15 SeCnV .X,.tle I (1
Name of person making statement JiName of person making.Statemprit
Personally Known OR Produced Identification t/ Personally Known V-' OR Produced Identification
Type of Iden ' ' ation Type of Identification
Produced Produced
(Si natur f No ary Public State of Florida ) (Si nature Notary Public-State of Florida)
Commission No. wy(SeBb)ary PublIC State of Flo ideo ission NO od* j'j S ry Public State of FI tl 1
Jennifer Dubien ? s" Je nifer Dublen
My Commission GG 1797 0 V My Commission GG 179 0 i
.1 F Expires 01128/2022 ��a n ' Expires 01128/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17