HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date: �1 �3`1g Permit Number: O;a, 0as3
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RECEIVED
Building Permit Application FEB 13 219
Planning and Development Services ST. Lucie County, PerMiaing
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
PRO'1?OSyED 1t1lP3VEMENT LOCATION
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Address: 1421 NW WINTERS CREEK RD PALM CITY FL 34990
Legal Description: Harbour Rdige Plat NO 15 LIVE OAK VILLAGE
TRACT G-12 LOT 12 ( OR 870-0727)
Property Tax ID#: 4426-825-0013-000-7 Lot No.
Site Plan Name: Harbour Ridge Block No.
Project Name: OAK VILLAGE
Setbacks Front Back: Right Side: Left Side:
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replace 9 windows to impact rated LOLL)
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Additionalwork to be ertormed
. under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ✓Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ l �L� - p� Utilities: ✓ Sewer Septic Building Height:
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Name JAY A KOERBER Name: Jeffery J Pauly
Address: 1421 NW WINTERS CREEK RD Company: Jeffery J Pauly Construction Inc.
City: Palm City State:FL Address: 2420 SW Mpalewood DR
Zip Code: 3499901 Fax: City: Palm City State: FL
Phone No. � , )"� �jL} Z Zip Code: 34990 Fax: none
E-Mail: Phone No. 772-263-8268
Fill in fee simple Title Holder on next page(if different E-Mail: jjpcbc.jp@gmail.com
from the Owner listed above) State or County License: #10811 CBC047770
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
5 � twMIVTI `ONSTRITtC}NI.1tt�l.AllU lNFC3RMATIQN
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: NA Name: NA
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: NA Name: NA
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 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 orney before
commencing work or recording otice of Commencement.
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_Sig r o O ner/Lesse Age Signat of n r for/Li se er
STATE OF FLmt..�
STATE OF FLORID
COUNTY OFu e:�� COUNTY OF 1.uC��
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this)�;L day of 20 Wby this S2?L—day of 20 \`\ by
Jcrr�v
(Name of person ack owledging) (Name of person ac nowledgi )
(Signature of Notary P lic-State of Florida) (Signature of NotBv Public-State of Florida )
Personally Known OR Produced Identification Personally Known OI ro+ _
Type of Identification Produced 1 L. Type of Identification Produced
EANNAMARIE
;;� �•, 022023
Commission No.G(:;OSa.pa. 4 MP NS Commission No. t A9106.
2020
DEAD #xO022023 *� K`iE EXPIRE . ndatwtite
MYrr. ISI 2020 «'��r� °= d M NOtary publicU
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Revised 07/15/2014 Bnermitting
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