HomeMy WebLinkAboutBuilding Permit Application r ;
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5\31 Permit Number:
MAY � 12019
IMP
Building Permit Applicati�i sT. iucle 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 X
PERMIT APPLICATION FOR: Window/door
P'RQ.POSED IMPROVEMENT-,-LO CATION ."
Address: 1104 Driftwood Lane Ft. Pierce, FL 34982
Legal Description: DRIFTWOOD MANOR-SECTION THREE-LOT 6 (0.50 AC)(OR 450-1149)
Property Tax ID#: 3404-808-0006-000-1 Lot No.6
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION.OF WORK: „
Replace 15 windows size for size - ,n, �q
CONSTRUCTION INFORMATION:
Additional work toe neFffo—rmed unclerthispermit—c ec a t a appy:
HVAC Gas Tank Gas Piping In Shutters z Windows/Doors
❑Electric ❑ Plumbing []Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 16261 Utilities:cnSewer❑Septic Building Height:
OWNER/LESSEE: 'CONTRACTOR:,
Name Shelton Peters Name: Roberto Sanchez
Address:1104 Driftwood Lane Ft. Pierce, FL 34982 Company: The Home Depot
City: Ft. Pierce State:FL Address: 6500 NW 12TH Ave. Suite 110
Zip Code: 34987 Fax: City: Fort Lauderdale State:FL
Phone No.772-216-0597 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.
41
SUPPLEMENTAL C(JNSTRUGTIQN L4EN LA1NaINFORMATlON '
: .
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:
1 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.
Signature of Owner/Agent/Lessee Signature of Contractor/LicenseliTolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF st Lucfe COUNTY OF St L.d.
The forgoing instrumiie��t was acknowledged before The for aing instrur�ept was acknowledged before me
me this day of I"l 20 18 by this day of I J 2018 by
If —
aLnw +o S&A h4,z- Roberto Sanchez Ashley Raines
Mal ��=s
(Name of person acknowledging) r"�E wikS � r" �� '" :O
4 � �-��a lame of person acknowledging)
NOTARY P, �{ S T ATE OF FLORtC
_STATE OF -LOR A _. w1F.� -A Comm#GG235648
Cornm#GC
Expires 7/0/2022
(Signature of Notary Public-State of Florida (SVg
riatur of Notary Public-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. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS