HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: O�
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 1 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATIO<N
Address: 9405 Pinebark CT Fort Pierce, FL 34951
Leeal Description: MONTE CARLO COUNTRY CLUB -UNIT ONE- LOT 162
Property Tax ID #: 1327-801-0051-000-8 Lot No. 162
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
REPLACEMENT OF 35 WINDOWS AND 3 DOORS(IMPACT)
Additional work to be ertormed under this permit —check all apply:
OHVAC 11 Gas Tank []Gas Piping _ Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: - S Ft. of First Floor:
Cost of Construction: $ 9 _71,nn`1��, CO Utilities:llSewer Septic Building Height:
Name Frances M Wolf
Address: 9405 Pinebark CT
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. (772)882-9237
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
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
.Address:
City:
Zip: Phone:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
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-covenantsthat-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
be re the first inspection. If you intend to obtain financing, consult with lender or an attorney before
mencing work or recording vour.Notice of Commencement.
Signature of Owner/ Lessee/Co tractor as Agent for n r Sig an ture of Contractor/License Holder
STATE OF FLORIDA STATE OF FL941DA
COUNTY OF L4,4 GI COUNTY OF 1-6(A ^Gpr
The forgoing instrument was acknowledged before me
this ,a- day of A-j�` 200 by
Fraln C'� INS , wd ( A
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced FL OC,
(Signature of Notary Public- State of Florida ) Cara A. Cluiroz
tN�Y
Commission No.(a'�; 13"11 �''O NOTARY PUBL
ESTATE OF FLC
a CommK GG134
REVIEWS. FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
The for oing instrument was acknowledged before me
this day of 20�by
Name of person rnakir& statement
Personally Known OR Produced Identification
Type of Identification
Produced -
GYA C� t t "At-/1�
(Signature of NotaJJryW
blic(itate of Florida )
Ifmmission No. . - oZ ?_ (Seal)
SUPERVISREVIEWORI PLANS REVIEW I VEGETEVIEWON SEA
Notary Public -
, 2022
y Assn.