HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /►
Date: �• Permit Number: l % d a O 0$o
RECEIVED
•
-- - - -- _- Building Permit Ap IicatiorIEB -5 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2360 Virginia Avenue,Fort Pierce FL 34982 t.. U I �0 U n ty, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMITTYPE:Window
PROPOSED-INPROVEMENT LOCATION 19024 Champions Way `
Address: 9024 Champions Way, Port St. Lucie
Property Tax ID#. 3334-501-0050-000-8 Lot No.—�
Site Plan Name: Block No. 04
Project Name:
DETAILED DESCRIPTION OF WORK:
Window Replacement a
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Joseph Tursi Name:Gary Whigham
Address:9024 Champions Way Company:South Florida Aluminum Products
City: Port St. Lucie State:_ Address:4807 So US Hwy 1
Zip Code: 34986 Fax: City: Ft. Pierce State:FL
Phone No. Zip Code: 34982 Fax: 772-466-1074
E-Mail: Phone No 772-466-0913
Fill in fee simple Title Holder on next page(if different E-Mail sfapbooks@soflalum.com
from the Owner listed above) State or County License CRC1330712
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Xvt" ATrnw Pg- Name:
Address: !Z A/-c- Address:
City: State: City: State:
Zip: 347 $ Phone - $G-/ 575 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 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 ilure to Record a Notice of Commencement may result in your paying twice for
improvements to your proper y. A Notice of Commencement must be recorded and posted on the jobsite
before the fir t specticip. If ou intend to obtain financing, consult withlender o attorney before
commencin. w rk or redord n our Notice of Commencement.
Signature f ner/ ontractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA, STATE OF FLORIDA
COUNTY OF— L 0CCOUNTY OF �� - �Z✓C/`-�
The for oing instrument was acknowledged before me The f ng instr a as acknowledged before me
this ay of 20 1--1 by this day of V 20 by
t'q 642::1 s'� A J/_ 44e 4,p-�
Name of p rson making st ement. Name of per on making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signatur -State of Florida (Signature of N a Public-State of Florida)
MARY ANN MATOt TI ::e�:
��,111l 1r�Seeaa 1 Commission �4: MARY ANN M6;gJ;4TI
Commiss o�►f . : ��„r......,��ION N FF953)38 - t' 3tbN l FF
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