HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l l' �. Permit Number:
RECEIVED
•
Building Permit Application OCT 1 12019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 t. Lude CO u n t�, FL
Phone:(772)462-1553 Fax: (772)462-1578 Commercial
PERMIT APPLICATION FOR: Window/door
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PROPrOSED�IfVI�PROVEMENTLO,CATION`s ' L:Ft r � �`" � r
Address: 59/9 "Xi tir Lc,h G ov-f Aeecz 3`� 5
Legal Description: Portafina Shores-Phase Two-(PB43-33)Lot 15(OR 3948-2843)
Property Tax ID#: 1312-502-0022-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILCRIPTIOI�
Replace 7 windows on house (See drawing for locations) GLS
Non impact glass- have existing shutters r �l ,��o u,
ST
CONRUCTION INFORMATION 3 3 y
s�._. .�.. d-
Additional work to be nPrformecl
uncler t ispermit—check all
Gas Tank E]Gas Piping Shutters Windows/Doors HVAC in _ Doors
— Q Windows
Electric 0 Plumbing Sprinklers E Generator 1-1 Roof Roof pitch
Total Sq.Ft of Construction: SFt. of First Floor:
Cost of Construction:$ c9Utilities: _Sewer O Septic Building Height:
OWNER%LESSE'E �4 r CONTRA TOR s
� r
Name _r� � /, ke Name: 40 r
Address: Company: Firestone Construction Inc
City: )Cl f 7 State:F� AddreVe
y-Clsi-111
Zip Code: 34951 Fax: City: 2 State:FL
Phone No.312-401-8484 Zip Code: 34945 Fax:
E-Mail: Phone No. 772-216-9379
Fill in fee simple Title Holder on next page(if different E-Mail: firestoneconst@gmail.com
from the Owner listed above) State or County License: CGC1510180
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIE1N INFORMATION r §
-, =tvi .. ,- -„}� �..,� +. ,�. �1�,��r.•, fi ,�.{ .�,t,'�.'2'fit,,x� ,....,...� .. .^:: «��t '� ,. ,r.,n.� - a �„' � .� � ,�
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Com. 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 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 attorney before
commencinp,work or recXdingyour Notice of Commencement.
i
Signature of Owner/Lessee/Contractor as Agent for Owner Signature ofContractor/License Holder
STATE OF FLORIDA - STATE OF FLORID
COUNTY OF COUNTY OF � 4—
The forgoing instrum nt was acknowledged before me The fo oing instru Lent as acknowledged before me
this day of 20]A by this 7 day of C 20A_by
KC\1 ) In ����c��� ---- may I` h C
Name ofperson aking statement Name of pers making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature o fi (Signature of N ry Public-State of Florida)
Ot�YPv'`"[�•S AUDREY B.HU HRR�jY --
Commission ;qc' ISSION# #0817 Commissi :;:;- rrPREY B.HUIV1PHfftaI)
^';:' •;�`,` EXPIRES:March 6,2023 �t� �”,, MY COMMISSION#GG 300817
L .p `'Y, Bended Thr hibfi = _
u Notary c Undenvriteru I - EXPIRES:March 6,2023
.. .,,---- Bone r
REVIEWS FRONT ZONING SUPERVISOR PLANS FGE SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17