HomeMy WebLinkAboutBuilding Permit Application A ,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
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 X
PERMIT APPLICATION FOR: Window/door
-RR(JPUSED IIVIPROI/EME`NT L(}CATION
Address: 5104 Myrtle.Drive Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 07-BLK 49 LOT 3 (MAP 34/02S) (OR 4.110-836)
Property Tax ID#: 3402-608-0305-000-7 Lot No.3
Site Plan Name: Block No. 49
Project Name: Parker Hambleton
Setbacks Front Back: Right Side: Left Side:
QETAILED DESCRIPTION OF WORK
:
Replace 1 door and 8 windows size for size (NOA 17-0144.06, 17-0630.8-7-, 17-0420.99)
AN
CONSTRUCl'IaN INFORM4TIC+N s yx
Additional work to be nerformed under tispermit—check all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction:$ 12151 Utilities:1:1Sewer ElSeptic Building Height:
aWNER/LESSEE CONTRACTt3R
Name Parker Hambleton Name: Roberto Sanchez
Address:5104 Myrtle Drive Company: The Home Depot
City: Fort Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34982 Fax: City: Fort Lauderdale State:FL
Phone No.772-321-9552 Zip Code: 33309 Fax:
E-Mail: Phone No. (754)224-2010
Fill in fee simple Title Holder on next page(if different E-Mail: Ashley.Raines@expeditepermit.com
from the Owner listed"above) State or County License: CGC1522717
If-value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPFLEMiENTAL C0NSTR66-T10N LIEN LA11t(fk 6 M,4T10N
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
j 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 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.
d7
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY OF St Lucie CO U NTY O F St Lucie
The for oing instrument was acknowledged bef The rgoing inst u ent w s acknowled eq efore me
me this day of MArGIr1 20 this day of 20 b
Roberto Sanchez Roberto Sanchez
(Name o pers ack ow dging) (Name of pe on ac w e ing)
(Signature of N tary Public-State of Florida) (Signature of Notary Pub ic-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 745 Ashley Rain' Commission No. a;7
� �•°•' �NCS��)f PUBLIC . Asp Pa*Y Raines
—STATE OF�LOMIDA ,",+`y ys:6.� NOTARY PUBLIC
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Revised 07/15/2014 s"Mce't9�0 Expires 71512022 =Corom#GG235648
Expires 7/5/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS