HomeMy WebLinkAboutBuilding Permit Application 1st pageALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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) 462-1S78 Commercial Residential
PERMIT APPLICATION FOR: u,+1166e
Address: I �r ) N IVOU
Legal Description: o�r phXJ
Property Tax ID #: ,,5L+ l`f — 7'E_ tp -CC ) 2
Site Plan Name: IV it �y
Project Name: '17—4� { q 'J sJ�°
Setbacks Front Back: ✓ Right Side: Left Side:
`o�TA)teo`o�s���PTI,aNaF u�o�i<:
Nuwuvna wulrc w oe
❑HVAC
envrmea
Tank
unaer cnis
E]GasPiping
permit—CneCK all
irlal apply:
1:1Shutters
_Gas
Electric
0
Plumbing
Sprinklers
ElGenerator
Total Sq. Ft of Construction:
Cost of Construction: $ n t 2 .
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Lot No. Itj)
Block No. a _
QWindows/Doors
11 Roof = Roof pitch
Building Height:
OUFIER_ 1LEs€E ,
CONTRACTOR.
Name i1 Ctis 1'i(L.LLc ��
C..
Name: Michael O'Donnell
Address Iql lA � � fCL t{ f
Company: O'Donnell Impact Windows
City:�r\ a %. � A f,l ; ; State:
Zip Code: 64CK ;2� Fax:
Phone No.
Address: 1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No. 772-408-0200
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: odonnellpermitting@gmail.com
State or County License: CRC1331273
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required,
SUPPLEMENTAL CONSTRUCTION LIEN LAW FORMATION:
DESIGNER/ENGINEER: _ Not Appl' le
MORTGAGE COMPANY: _ Not cable
Name:
Name•Micheei000 en
Address:
Address:
City: State:
City: swan State: _
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HR: _ Not Applicable
E
BONDING COMP _Not Applicable
Name: /O�I,
Name:
Address:»60 NW_fMml Hwy
Address:
City:
City: s
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby ade 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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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
cornmencing work or recording our Notice of Commencement.
fSignature
of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY
COUNTY OFj{ �l i
iOF
The fnoirtg instr ment was acknowledged before me
this v�+_+ day of �-r-}-?- _ . 20 by
The foLgo 19 instr,ment wa ,acknowledged before me
thisrr day of t' ' 20 by
y�
Name of person mg statement
Name of persoU, ing statement
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(HAA d&\�
✓
I
(Signatur f Notary Public—Sta - 3 -.
ISIgKit of NotaryPublic- State of Flarida }....;-._:
!�qc e WYNN ALLEN
Commission No. a " t/ TY Publ(Se*te of Florida
3'= ommission # FF 923070
'.�,�,��;° My Comm. Expires Sep 30, 2019
. a ;;a•�R.dd
-,. "c",•, WYNN ALLEN
Commission No. "� ' � .0tary F)- State of Florida
=° 4 d °= Commission # FF 923070
.. '9,F.o°�� My Comm. Expires Sep 30, 2019
;;,. ",,.
SEA TURTLE
MANGROVE
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17