HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
_ & 2 - nn
RECEIVED
Building Permit Application
Planning and Development Services DEC 0 2 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FC 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
AC#PO$EDImpkb-lEl i4OCA`o�
Address: 2407 Atlantic Beach BLVD Hutchinson Island, FL 34949
Legal Description: FORT PIERCE SHORES-UNIT 1-BLK 4LOT 12 AND NLY 21.27 FT LOT 13
Property Tax ID#: 1436-601-0073-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
C}ETA�LED'DSRIPTICsI� OW14
ORK
REPLACEMENT OF 10 WINDOWS AND 1 DOOR (IMPACT)
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CONSTRUGIOI IN1=(? jIATI )N
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Additional work to be performed under this permit–c ec<all that appy:
❑HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
Electric ❑ Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ G21�i(O w Utilities: —Sewer❑Septic Building Height:
QU1/NERjLESSEE Ff a
CONTRACTOR
Name David,a�ALV ar Name: Alphonse Campanelli
Address:2407 Atlantic Beach Blvd Company: STORM TIGHT WINDOWS
City: Fort Pierce State: FL Address: 500 SW 12TH AVENUE
Zip Code: 34949 Fax: City: DEERFIELD BEACH State:FL
Phone No.(305)281-9812 Zip Code: 33442' Fax: 754-227-7891
E-Mail: Q§Mb 2-41,0r(W 0tf, ,,e 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.
�,.;� PPt�EM�NT�L CONSI"Rl1CT'ION t=IEN�L/�1flC INFORI\IIATCQ�`(�
,
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 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
commencing work or recording our Notice of Commencement.
Q" P� = 1
Signature of Owner/Lessee/Contractor as Agent for Owner Signature 6f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF Ot-6
The for ping instrument was acknowledged fore me The fo ing instrument was acknowledge fore me
this day of s� 20 by this day of 20 by
Name of person making statement ' / , of' pi-irDAing statement
Personally Known - OR Produced Identification v Personally Known v OR Produced Identification
Type of Iden ' ' ation� Type of Identification
Produced Produced
- CL
GOVICH
(Signature of Nota �• 'atH�ltobida hate of Florida (Signature of Notar ub f Fdo�a�ry Iic State of Florida
Commission k GG 207273 `
r 15,2022 > Commission K GG 207273
Commission No. F,•., � ����p Commission No. `/� y Com(GoliYes Apr 15,2022
Bonded through National Notary Assn. Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
.COMPLETED
Rev.8/2/17