HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFOM ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / Permit Number: Cq0
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BuildingPermit Application�� Permitting Department
Planning and Development Services St.Lurie County
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
PROPOSED IMPROVEMENT'LOCATI=QN ,
Address: 379 SE Gasparilla Avenue, Port Saint Lucie, FL 34983
Legal Description: River Park- Unit 4 BLK 37 LOT 21
Property Tax ID#: 3419-530-0149-000-9 Lot No.21
Site Plan Name: Block No. 37
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION`OF`WORK
CONSTRUCTION, INFORMATION
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ ��5��1 " Utilities: D_Sewer 0 Septic Building Height: 2
01NN ER/LESSEE gar, CONTRACT
Name Barbara Berry Name: Scott Berman
Address:379 SE Gasparilla AvenueCompany: Florida Window and Door
City: Port Saint LucieState:FL Address: 1125 N. Dixie Highway
Zip Code: 34983 . Fax: City: Palm Beach Gardens State:FL!I
Phone No.954-253-1627 Zip Code: 33418 Fax: 561-624-8037
E-Mail: Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different E-Mail: Howard@floridawindowanddoor.com
from the Owner listed above) State or County License: CGC-1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LA1N INFORMATION,
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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.
S
Signpture of wner/Lessee/Cont actor as ent f&-Owner Signature of Contract r/ a Holder-
STATE
olderSTATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L3 Gam.e— COUNTY OF (, yn
Thefo going instrument was acknowledged before me The for oing instrum nt w s acknowledged-before me
this I day of �y V I 20�by thisoday of 20 l`� by
Barbara Berry 1 Scott Berman
(Name of person acknowledging) (Nam person ackn wledging)
(Signature of Notary Public-Nate of Florida) (Signature of Not@N Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced r(_i_t Type of Identification Produced
Commission No. Ff"9 a05110 (Seal) Commission No. a
IhUoslavaNOMandez A"Myy� Notary Public S ate of Florida
ptary PubP,c Carol A Hammersla
o
_0 Pub. State of F on a •- "on GG 343472+o�A�► Expires 0710912023
Revised 07/15/2014 ,<: isstonExpires91211201t
My Comm F 920540
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