HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:-'��,q 9., Permit Nu
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SEP 5 2019
_,... _ _......:_-.. Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential x
PERMIT TYPE:WINDOW REPLACEMENT
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Address: 5900 KILLARNEY AVE
Property Tax ID#. 1301-613-0028-000-1 lot No. j
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Site Plan Name: Block No.
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Project Name:
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REPLACE 1 OPENING OF EXISTING WINDOWS WITH CGI IMPACT WINDOWS
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Additional work to be performed under this permit-check all that apply:
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_Mechanical _Gas Tank _Gas Piping _Shutters -Windows/Doors
_Electric ,Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost
(((off}Construction:$ 2,077.89 Utilities: _. Sewgerr `Septic Building Height: �
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Name JEAN FRAZIER Name:ROY MICHAEL JOHNSTON
Address:24494 LANIER STREET Company-STUART PAINT&SUPPLY
City: TALLAHASSEE State: FL- Address:657 NE DIXIE HWY
Zip Code: 32310 Fax: City: JENSEN BEACH State:FL
Phone No.850 524-1595 Zip Code: 34957 Fax: 772 334-2705
E-Mail: Phone No 772 334-2700
Fill in fee simple Title Holder on next page(if different E-Mail mjohnston@thebuildersstore.net
from the Owner listed above) State or County License CGC 1517946
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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DE5iGNER/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.
1 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 JOB WTE BEFORE THE FIRST INSPECTION. IF YOU ND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER O AN ATTORNEY BEFORE RECORDING YO O COMMENCEMENT:'
Signa r of Owner/Le seee/Contra o as Agent for Owner Si tore f Contractor/Liven er
STT Y FLORID STATE Of FLORIDA y,��C��ll�_
CO TY Of COUNTY Of `—i -E
Theljgoing inst ent was acknowledge efore me The forgoing instrument was acknowledged before me
thi9 ``. day of 20tby this_jday of r�Qu 20 by
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Name of person making statem t. Name of persqn making statement.
Personally Known ed Identification P(*sonally Known OR Produced Identification
Type of Identification Type of Identification
duced Produced
L1--r ,(-— Produced
tee,t£a eRR MIM1MM4$.Jate of Florida) (Signa re, 1 tar 4 fkSftt'p}�� e o ori )
oma: fres August 21,2022 a� anne 4Lni
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE t
RECEIVED
DATE
COMPLETED
Rev. _
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