HomeMy WebLinkAboutBuilding Permit ApplicationALL 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) 462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address:
Legal Description:
Property Tax ID#: IQI/--�4)01—
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Site Plan Name: �9 Yii4e'��'ji rju. , ".—
ProjectName• 9 iKru;-sk; j
Setbacks Front•_ Back: _V Right Side:
Total Sq. Ft of Construction: n
Cost of Construction: $.d f , .F
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Lot No.
Block No.
Left Side: e
S Ft. of First Floor:
UtilitiestSewer 0Septic Building Height:
�1�VI�tES,E
G.ONTRACTOR;
Name 1 c
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Name: Michael O'Donnell
Address: QR a /3 UL&
Nn Ve—
Company: O'Donnell Impact Windows
City: 4 , ;�a', State:{
Zip Code: 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: odonnelipermitting@gmail.com
State or County License: CRC1331273
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CG STRUCTION LIEN LAW
TION:
DESIGNER/ENGINEER: _ Not Appli ble MORTGAGE COMPANY: _ Not Applicable
Name: Name:Michael o•oeniien
Address: Address:
City: State: _ City: Stuart tate: _
Zip: Phone Z Zip: Phone:
IEEnSIMPLE TITLE HO, ER: _ Not Applicable BONDING COMPANY: Not Applicable
Name:
Address: »<oNw5 emlHw Address:
Zip
Zip: / Phone:
MER/ CONTRACTOR AFFIDVIT: Application is hereby made to o in a permit to do the work and installation as indicated.
--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 Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attornev before
reli
of Owner/ Lessee/Contractor as Agent for Owner I Signature of
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF '� COUNTY OF ak14( L' ,,
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Name of person mg statement
Personally Known OR Produced Identification
Type of Identification
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WYNN ALLEN
Commission No..J�Qyfry Puhl(6e�Qste of Florida
y - ommission # FF 923070
:I '%� aI M Comm. Expires Sep 30. 2011
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The f fg instr ent�was ckr�owledged before me
this , day of `Q I �ru • 20_41 by
Name of persopwlaOng statement
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Type of Identification
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_ wYNN ALLEN
Commission No. ' A ' ,1,idotary"ll-State of Florida
`� a •= Commission # FF 923070
My Comm. Expires Sep 30, 2019I
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