HomeMy WebLinkAboutBuilding Permit Application a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date::1 3��� Permit Number: Aldi~d a 15
0111111111
I ;;;_=_- --; RECEIVED
o -
-- - Building Permit Applicatio SEP 1 3 ?019
Planning and Development Services'
Building and Code Regulation Division ST. Lucie County, Permitting
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 LOCATION:
Address: 368 Traub Ave., Fort Pierce, FL 34982
Legal Description: Regina Palms S/D BLK 10 Lots 34 to 36 Inc(0.54 AC) (OR 3840-2693)
Property Tax ID-#: 3403-501-0268-000-0 Lot No. 34 to 36
Site Plan Name: Block No. 10
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Demo (3) existing windows and supply and install (3) PGT Series SH-5500 PVC Single Hung Impact
Windows to existing openings/ Supply and Install (1) impact French Door
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check all appy:
HVAC Gas Tank E]Gas PipingShutters Q Windows/Doors
_
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5,319.44 UtilitieslnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Jessie Wilson Name: John Jacobs
Address:368 Traub Ave. Company: John Jacobs Construction Inc.
City: Fort Pierce State:FL Address: 4701 Oleander Ave.
Zip Code: 34982 Fax-772-466-6491 City: Fort Pierce State:FL
Phone No.772-882-8334 Zip Code: 34982 Fax: 772-466-6491
E-Mail: Phone No. 772-882-8334
Fill in fee simple Title Holder on next page(if different E-Mail: imiacobs4701@gmail.com
from the Owner listed above) State or County License: CBC060421 /19245
If value of construction is$2500 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 thepermit 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.
Signature f Owner/Lesse ontractor as Agent for Owner Signature o ontractor/Licens older
STATE FLORIDA STATE O LORIDA
COUNTY OF '51 cA C ; COUNTY OF C,c C i
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�hday of Susi-er,1i ae ,20 cL by this Ilf~day of Se�te.�,bar ,20 19 by
d.
-5o c'o V--,S r\ �o•co b-s
Name of person making statement Name of person making statement
Personally Known_X OR Produced Identification Personally Known_ ( OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Nota blit-State of Florida) (Signature of Nofgiry Public-Sta o Notary Public State otFl id ii
Casey Binkley
Commission No. 90688 Seal Sion No °10 840 +� 9061 8C
o�pr x4� Notary Public State of orida
'Dyat Expires 08122/2023
F.
Casey Binkley
Wip4ffi
Nxpues oer2212o23
REVIEWS FRONT VEGETATION SEA TURTLE MANGROVE
COUNTER R REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17