HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \ Permit Numb :_R
22R
R
JAN 04 2019
Building Permit Application
ST. Lucie County, Permitting
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 Residential ✓
PERMIT APPLICATION FOR:
PROPOSED IIVIPR01lEMENT LCATI4N P
Address: 1107 KINGSWOOD LN FORT PIERCE FL 34982
Legal Description: DRIFTWOOD MANOR-SECTION TWO-LOT 12
Property Tax ID#:3404-807-0012-000-3 Lot No. Jz
Site Plan Name: Block No.
Project Name:PAUL& SHEENAGH KUKLA
Setbacks Front Back: Right Side: Left Side:
xut 1
DETAILEI] DESCRIPTION$ 7F WORK F -
ta'`
a
Replace 16 Windows
r�
}CQNSTRUCTION INFORMATION
Additionalwork to ff
rorme un er t is permit—c ec a app y:HVAC Gas Tank Gas in Shutters Windows/Doors
_
❑ Piping
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 20,000 Utilities:11Sewer OSeptic Building Height:
n a 'i Ye kg i e e t i
OWNER/1-ES5.EE E CONTRACTOR ;
Name PAUL& SHEENAGI-I KUKLA Name:I)AN 13ECK1NE12
Address: 1107 KINGSWOOD LN Company: PARADISE EXTERIORS I.,LC
City: FORT PIERCE State: FL Address:1918 CORPOIZATE DI2
Zip Code: 34982 Fax: City: BOYNTON I3EA(I,I1 State:FL
Phone No. 772-971-6836 Zip Code: 33426 Fax:
E-Mail: Phone No. 561-732-0300
Fill in fee simple Title Holder on next page( if different E-Mail: par,,idiseexteriorsllc.Crb,t)in til.com
from the Owner listed above) State or County License:SCC131150472
If value of construction is$2500 or.more,a RECORDED Notice of Commencement is required.
� s
SUPPLEMEfVTAL`&CUNSTR UNCTION LIENg 1J INiF�ftMATICIN '
.
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:
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 yo intend to obtain financing, consult with lender or an attorney before
a
commencing work or rec r n o r Notice of Commencement.
,C
41na-ture of O er/ g t/Lessee Sign e of Contractor r---
STATE OF FLORIDA nA I r 0`E STATE OF F ORIDA�.. / U G ( ,�
COUNTY OF `�- Vii ,� C�
The forgoing instrUuwt was acknowledgedlefore me The forgoing instrument was acknowledged before me
this day of t 20?_by this GA day of 0 1 ,20�by
-ppi , e I
(Name of person no ledging) (Name of person acknowledging}
(Signature o tary
Public- tate of Florida) (Signature of Notar��roducecl
to of Florida}
Personally Known Produced Identification Personally Known Identifica i
Type of Identification Produced Type of Identification ProdCARIE CARA
°, my�OVif ISSION#GG 205763
Commission No. q, Sion No. =x I1 ES:April 10,2022
6T0Z'ZZn4—r&S SHaIdXH ' �=
ZL99hZd3#i�IOiSSIYYIWWO�CNI �'•Fp F;°Q Bonded Thru Pdotary Public Underwriters
dna n�i�
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS