HomeMy WebLinkAboutBuilding PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ Permit Number:
O
• _ r
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 APPLICATION FOR:
PROPOSED
IIUIPfROV) IVI,ENT
LC}CTPON:
Address:
Legal Description:
/�
Property Tax ID #: q,*' cc - / 1 / (1�7 0 - c, P Lot No.
Site Plan Name: `J Block No.
Project Name:
Setbacks Fronts Back: V11, Right Side: LeftSide:
DETAILED
DSCRIPTOiOF Udf(YfK:, .
l
acted_%s-n 13 s.,T
COIVSfRUCT)OIV INFORMATION,
..
Additional work to-beneorme un ert ispermit-checka apply:
[1HVAC 11 GasTank -]Gas QWindows/boots
_Shutters
11 Electric Plumbing F]Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
> 4/ t7 ElHeight:
Cost Construction: � 0
of $ F Utilities: Sewer Septic Building
O'V4 NERjLESSEE
CONTRACTOR
Name
Name: Michael O'Donnell
Address:
Company: O'Donnell Impact Windows
City -
Address: 1740 NW Federal Hwy
City: Stuart State:FL
_State:
Zip Code: !3qq .�^y?L�rFax:
ppp
Phone No. � 7gc O a
Zip Code: 34994 Fax:
E-Mail:
Phone No. 772-408-0200
Fill in fee simple Title Holder on next page (if different
E-Mail: odonnelipermitting@gmall.com
State or County License: CRC1331273
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN INFORMATION:
DESIGNER/ENGINEER: _Not licable
MORTGAGE COMPANY: _ Not Ap 'cable
Name:
Name: tmichael O'Donnell
Address:
Address:
City: State:
City: Swart State:
Zip: Phone
Zip: Phon
FEE SIMPLE TITLE LDER: Not Applicable
BONDING COMP*NY: _Not Applicable
Name:
Name: r
Address:»<o FedeaiHw
Addres
City:
Cit
Zip: Phone:
p: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 1 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
cornmencing work or recording our Notice of Commencement.
6gnature
Signature of Owner/ Lessee/Contractor as Agent for Owner
of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ( j/\
COUNTY OF
The f r it instr , en was acknowled e before me
thisday of 20 by
The fo o,�' mstru nt acknowled e efore me
this day Of ( 20' by
M
I
Name of pmoamWiFirig statement
Name of person ing statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signatur f Notary 'Pubhe StatexrfxE!
(Signat of Notary -Public- State of Florida..)
�"%f"nP���77�y WYNN ALLEN
Commission No. F/'PYPrY Publ(6e�i�yte of Florida
Mwi,�=
� .� � /;` WYNN ALLEN
Commission No. -�- o •a dotary �- State of Florida
ommission # FF 923070Commission
My Comm. Ezplres Sep 30. 2019
# FF 923070
° %;� �' My Comm. Expires Sep 30, 2019F�
.''
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/ll