HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Ig � a - 010
Building Permit Applica ion
PFCZVED
Planning and Development Services DEC 0 5 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie Coun , P Itting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT APPLICATION FOR: Window/door
,,PROPOSED IMPROVEMENT LOCATION:
Address: 1545 NW BUTTONBUSH CIR PALM CITY, FL 34990
Legal Description: HARBOUR RIDGE- PLAT 13- BUTTONBUSH VILLAGE UNIT 26
Property Tax ID#: 4426-815-0033-000-2 Lot No.
Site Plan Name: Block No.
Project Name: WILLIAM HARRISON
Setbacks Front Back: Right Side:_ Left Side:
DETAILED DESCRIPTION OF WORK 00,
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Ad itional work to e e orme uncler this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:_ Srt. of First Floor:
Cost of Construction:$ Cj� Utilities:cn Sewer[]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name WILLIIAM HARRISON Name: Scott Berman
Address: 1545 NW BUTTONBUSH CIR Company: Florida Window and Door
City: PALM CITY State:FL I Address: 11125 N DIXIE HWY STE D
Zip Code: 34990 Fax: City: LAKE WORTH State:FL
Phone No. _ I Zip Code: 33460 Fax: 561-624-8037
E-Mail:WWHARRISON@ME.COM Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different ; E-Mai;: Howard@floridawindowanddoor.com
from the Owner listed above) State or County License: CGC-1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 Assoaatio:,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
commencinR work or rf!cording your Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner_ Signature of Co cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 4 dayof CSGzp0FV 20 LBaby this �- day of L(AtoCL 20 r
paenpp 3D
110*4 1�
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WILLIAM HARRISON Scott Berman -
( a e of person ac owledging) (Name of person acknowledging) J�ccco
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(Signa ure o of Public-State of Florida) (Signature of Notary Public-State of Florida) to
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Personally Known OR Produced Identification Personally Known ( OR Produced Identi i0f
Type of Identification Produced �V"� Type of Identification Produced -n
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Commission No. SHIRLEYSNIRLEY A.S mid i n No. (Sea o y
}� Notary Public-St to o ori n
Commission+y G 061648 m
My COMM. x .
Revised 07/15/2014 Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS