HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number: 1 `l`7�- _ 0")Uq
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
PRQPOSED IMn[?RCMVEMENT Lt3CATI�N
Address: 410 VUllows AVE Port Saint Lucie, FL 34952
Legal Description: RIVER PARK -UNIT 2- BLK 17 LOT 8
Property Tax ID #: 3419-510-0197-000-8 Lot No. 8
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
REPLACEMENT OF 10 WINDOWS (IMPACT)
Block No. 17
Additional worK to be ertormed under this permit — check all h apply:
1:1HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 17,178 Utilities:cn Sewer Septic Building Height:
Name Shiela A Soler
Address: 410 Willows AVE
City: Port Saint Lucie State: FL
Zip Code: 34952 Fax:
Phone No. (772)631-5633
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from.the Owner listed above)
Name: Alphonse Campanelli
Company: STORM TIGHT WINDOWS
Address: 500 SW 12TH AVENUE
City: DEERFIELD BEACH State: FL
Zip Code: 33442 Fax: 754-227-7891
Phone No. 954-320-7554
E-Mail: stormtightpermits@outlook.com
State or County License: CRC046091
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone:_
Not Applicable I BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 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 Contractor/License H der
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLWIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF / C)I,/?.
The fo going instrument was acknowledged before me
The forgoing instrument was acknowledged before me
iday
this day of (it5� rG%1 20n- by
this of MR /C.%1 206 by
Name of person making statement ✓
Name of perso aking statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Ide fication
Produced FLbL--
Produced 7j'J)C_
Notary Public State of Florida
(Signature of N Y �cN�t �Sg;F grad Florida
(Signature of N atate�C�gP't�l' pp
. Aiy Comm- Apr 15, 202Z
o` C�om["ission x GG 207273
Commission No. p• %C7a. Expires (MAP) 2022
of F`4
through National Notary Assn.
Commission No.4-7
Bonded t rough National Notary Assn.
REVIEWS;
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17