HomeMy WebLinkAboutbuilding permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �c�' '� l 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
PERMIT TYPE:WINDOW/DOOR INSTALATION
SRROP.OSED'IMPROVEMENT.LOCATION:
Address: 13521 S INDIAN RIVER DR 1005
Property Tax ID#i: 4509-804-0066-000-2 Lot No.
Site Plan Name: Block No.
Project Name: KELLENBERGER
aDETAILED.D,ESCRIPTION;OF WORK:
f z,,
REPLACE SLIDING GLASS DOOR WITH IMPACT.
USING LIKE SIZES.
NO STRUCTURAL CHANGES BEING MADE.
TRUCT�ON INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters V Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 5613 Utilities: --Sewer _Septic Building Height:
01rUNER/LESSEE> CONTRACTOR:
Name Charles Kellenberger Jacqueline Kellenberger _ Name:BRUCE M.TYRRELL,JR
Address: 10 Myrtle ST Apt 3 Company:KAMRELL WINDOWS&DOORS
City: Waterville _ State:CtC Address:2201 SE INDIAN ST BLDG Q-4
Zip Code: 04901 - Fax:. City: STUART State: FL
Phone No.207-660-5842 Zip Code: 34997 Fax: 772-288-6208
E-Mail:CHARLIEK@ROADRUNNER.COM Phone No 772-288-6205
Fill in fee simple Title Holder on next page (if different E-Mail ADMIN@KAMRELL.COM
from the Owner listed above) State or County License CGC061180
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 Appl icable
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:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WJUEKTOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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6-41 Z
Signature of Owner/lessee ontractor s Agent for Owner Signature of Contractor/Lic se Hold
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF_ +)1Ct(-Ir I(1 COUNTY OF mct( t
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�t2lay of ]j:VL4rq ,20 (ct by this!ai r aay of Fe19(L4(L4 201 by
Name of person making statement. Name of person making statement.
Personally Known 1/'OR Produced Identification Personally Known Lam--OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Awrllcll
(Signature of Notary Public-State of Florida) re of Notary Public-State of Florida)
�/�� SUSAN M GODD RD
Commission No. 0 `Ppv1Pt1_�al) `
,ro• !�, Notary Public•State fRaortdai ion No.
o�'�Ji'r'���.,, SUSAN M 130091)#;
Commission 8 GG 33219 ; Notary Public-Statrids
"' d•'� y i n Notary Assn. �' •' omm as on-#GG 3 9
REVIEWS FRONT O)VII " VEGETATION SEA. ' M M�l'R}UI ► fLSBD 5 020
COUNTER REVY R VIEW REVIEW REVIEW R e nde ionalN tar JAssn.
DATE
RECEIVED
DATE
COMPLETED