HomeMy WebLinkAboutBuilding Permit ApplicationX.
8
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
P:RQP05ED liU1PRC}UEM'EI T LO.CAT1QN
Address: 5308 Hickory Dr Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES -UNIT 07- BLK 52 LOT 20
'Property Tax ID #: 3402-608-0460-000-1
'Site Plan Name:
Project Name:
Setbacks Front Back: _
DETAILED D]ESCRIP'1IO' CIF UItd
Right Side:
Lot No. 20
Block No. 52
REPLACEMENT OF 8 WINDOWS AND 1 DOOR (IMPACT)
i
Name Sandra Moge
Address: 5308 Hickory Dr
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-465-8092
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Left Side:
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.
Gall
1- 0- M I
DESIGNS
Name:_
Address:
City:
Zip:
GINEER: _ Not Applicable
Phon
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:.
BONDING COMPANY:
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 con currency 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
limprovements 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
Icommenciri work or recording our Notice of Commencement.
X
Signature of Owner/ Lessee/Contractor a Agent for Owner
Signature of Contractor/License Holder
STATE OP FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTYOF
The forgoing instrument was acknowledgeefore me
this 0 day of JO) 20 by
The forgoing instru +m+e t was acknowledged before me
this qpL day of V 201!E by
Name of person making statement
Name of person a sta e
Personally Known d Identification
Personally Known roduced Identificat n
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Type of Identification7
Type ntific '
Produced
Produ ed
(Sign c-Sta e
(Sign of Not lic-Stat FII da)
VERED INSTt)�
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Rev. 8/2/17