HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
• _ AUG 2 9 2019
Building Permit Appli ation
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential l/
PERMIT TYPE: 146u,s5 �o 5
PROPOSED IMPROVEMENT LOCATION:
Address: 5512 DAVIS STREET,FT PIERCE,FL 34982
Property Tax ID#:3409-111-0020-010-4 Lot No.
Site Plan Name: Block No.
Project Name: GARY& CATHERINE PETZOLD
DETAILED DESCRIPTION OF WORK:
Replacement Windows(6)and Doors(1) /YNQ5A '}
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
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Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
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_Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 149330 Utilities: —Sewer _Septic Building Height:
QWNER/LESSEE:- CONTRACTOR:
NameGARY& CATHERINE PETZOLD Name:Sam Ochstein
Address:5512 DAVIS STREET Company:Newsouth Window Solutions
City. FT PIERCE State:FL Address:2526 Okeechobee Blvd.
Zip Code: 34982 Fax: City:West Palm Beach State:FL
Phone No. Zip Code: 33409 Fax:561-478-4100 j
E-Mail: Phone No 5&t--"2--"00 1-0.—5W-0a1 11�Z,
Fill in fee simple Title Holder on next page(if different' E-Maili
from the Owner listed above) State or County License CRC1330822
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.
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SUPPLEMENTAL-CONSTRUCTION LIEN LAW INFORMATION:,
DESIGNER/ENGINEER: _Not Applicab MORTGAGE COMPANY: _Not Ap li
Name: Name:
Add ress: Address:
City: State: City: State:
Zip: Phone Zi Phone:
FEE SIMPLE TITLE HOLDER: NoApptl-ca-bTe BONDING COMPANY: pplicable
Name: Name:
Ad d cess: Address:
City: City:
Zip: Phone: Zi 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 an 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, j
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,jAND
POSTED ON THE JOB SITE BEFORE TH T INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOVR LENDER OR AN OR RE RECORDING YOUR NOTIC F. OMMENCEMENT"
Si" ature ner/Less ont clot as Agent for Owner Signature of ontra or/ icense Holder
STATE OF FLO D STATE OF FLORID
COUNTY OF G O�C COUNTY OF ��M �1j eacl-N
The for ni instru Tent was acknowledged before me The for o'nginstru nt was ackn wledged before me
thi day of U� ,20 I q by thisaybf ,201 by
Name of pers n making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known P
Type of identification Type of Identification JENNIFER AV7CE bis
Produced_ (_ Produced �`o1Pavnua4l State of Florida-Notary,
.commission # GG 196943
My CommissionExpiTes
/'1• oFMarch 15, 2022,
{Signature of Notary Public-Sta da I PHILIP G. PER na re of ary Pu is-State of Florida )
V V
/f'' 'y �
State of Flonda-Nota y Igo
•f �(,+� ( ommission # GG 66547
Commission Nolte-I a�jMy Commission pcami ion (Seal)
December 10, 2021
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