HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO IWUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: va + Permit Number:
T
RECEIVED
Building Permit Application DEC 0 7 7018
Planning and Development Services ST. Lucie County, Perrtliwnp
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 g}atter-. �•` hadtio 5
PROPOSED IMPROVEMENT LOCATION:
Address: 12737 S Indian River Drive,Jensen Beach,FL 34957
Legal Description:EDEN'S REFUGE LOT 1(OR 3875-1352)
Property Tax ID#:4504-702-0001-000-1 Lot No,
Site Plan Name: Block No.
Project Name:Sheri Kern
Setbacks Front Back: RlghtSide: Left Side:
DETAILED DESCRIPTION SOF WORK:
Replacement of 18 Windows.a -Beer..
CONSTRUCTION INFORMATION:
it ona wor fto orme undert s permit—check a appy:
OHVAC_ LlGasTank Gas Piping Shutters Windows/Doors
Electric ❑Plumbing Sprinklers 0 Generator 0 Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 31000.00 Utilities: Sewer 1:1Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name" eri -Name,Toby,Tokes
Address- 0J7 S'TndianRiver Drive Armory
'` Company ue V�indow&Door
Clt.,Jensen)Beach' " State: FL Address.,1000 Clint=lyIoore Rd Ste 109
Zip Code '3495TH'' Fax: - City:Boca Raton.-,•,.; State:FL
Phone No. 940-367-4430 Zip Code:33487 Fax:561-826-9180
E-Mail: Phone No. 561-988-4222
Fill in fee simple Title Holder on next page(if different E-Mail:
LLIf
m the Owner listed above) State or County Ucense:CRC1330842
lueof construction Is$2500 or mare,a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applit:able
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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no represent tion that is granting a permit will authorize the permit holder to build the subject structure
W is in oon 11ct with any applicable Home Owners Assoc permit 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.
Signature Owner) gent/Lessee Signat of Co;Rt'l
o License.Holder
STATE OF FLOP 2 STATE OF IA
COUNTY OF I'at^ WCi'� COUNTY of I vin Beacib,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this L-day of —ILA k4� 20 10 by this %-I day of_ 1A\14 20_1!1,by
a(Naperson acknowledging) (Name of pefson acknowledging)
.I - )*�-d' I e�2-� A 466
(Signature of Notary Public-State of Florida} (Signature of Notary Public-State of Florida}
Personally Known Y' OR Produced Identification Personally Known_6 OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. r g>0go Notary Public State f / hhyy.. _ Notery Public State of F ]idaia� .� El�fidAti n No.(aC �'/ � �41)gim�D Rottler
Aimee D Rottlerssion GG 226880 +�c My Commission 22 22
F�cpires 08I10f2022
Revised 07/15/2014
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