HomeMy WebLinkAboutBuilding Permit ApplicaitonAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/08/19
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
PERMITTYPE:Window/Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 12793 NW Cinnamon WAYPalm City, FL 34990
Property Tax ID #: 4425-602-0031-000-1
Site Plan Name: MARINER VILLAGE HARBOUR RIDGE
Project Name: Solomon Residence
DETAILED DESCRIPTION OF WORK:
Remove and replace impact CGI SH 110 (NOA# 17-1018.08), PW 130 (NOA# 19-0603.02),
CGIC SS 3520 (FL PA# 25883.1)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Block No.
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 47,300
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameH Ronald Solomon
Name. David LaPrade
Address:12793 NW Cinnmmon Way
Company:The Glass Professionals
City: Palm City State: _
Zip Code: 34990 Fax:
Phone No.772-336-6116
Address:3570 SE Dixie Hwy
City: Stuart State: FL
Zip Code: 34997 Fax: 772-286-0461
Phone No772-286-0459
E-Mail:ronsolo306@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail permits.glasspros@gmaii.com
State or County License 11363
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 COMMENC ENT MUST BE RECORDED AND
POSTED ON THE JOP SITE BEFORE THE FIRST INSPECTION. IF Y INTEND OB I FINANCING, CONSULT
13M
WIITH,YOQUJERJOR NEY BEFORE RECORDING YO R N F NCE ENT."
I
Sign a ure o wn [eYseeTC11ractor as Agent for Owner
Signature o ontrac or icense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MajVhi'1
COUNTYOF_ �MGLV��1r1
The forgoing instrument was acknowledge before me
this V day of U�(;I� 20 by
The forgoing instruXnent was, acknowledge
,d before me o
this 1- day of t ' •20 VI by j
H
_�L
�(AVi(i 1 ((Pyad e
IXtVid �,%, � a
Name of person making statement.
Name of person making statement. i
L-
Personally Known OR Produced Identification
Personally Known OR Produced Identification m: �
�i
A� .=
Type of Identification
Type of Identification LL
F
Produced
Produced �rr
' (Signature of Notary P blic- State of Florida)
(Signature of Notary Pu lic- State of Florida)
Commission No (f'j �JL-+ (seal)
° �
Commission No.(�?�3��7 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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