HomeMy WebLinkAboutBuilding Permit Application i
All APPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:! �- I Permit Number:
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��ti�s��Y�-�` `'e -�_�,-�; � 'OCA �c�`►
Building Permit Applicationo,
Planning and Development Services o�'�3�'�
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
J
PROPOSED IMPROVEMENT LOCATION: -
Address: 3120 Marvilla Blvd,Fort Pierce;FL 34982
Property Tax ID#:2428-601-0189-000-3 Lot NoJ5,16114 17
Site Plan Name: Block No.D
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Project Name: Tommy M York,Caroline J York
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DETAILED DESCRIPTION OF;WORK:
Replacement 12 Windows and 0 Doors
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CONSTRUCTION INFORMATION: :.
Additional workto be performed underthis permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _'Shutters -1/windows/Doors
Electric —Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 16600.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE . , ,CONTRACTOR:
NameTommy M York,Caroline J York Name:Sam Ochstein
Address:3120 MarviHa Blvd Company:Newsouth Window Solutions
City: Fort Pierce State:FL Address:2526 Okeechobee Blvd.
Zip Code: 34982. Fax: City:West Palm Beach State:FL
Phone No.772-359-0087 Zip Code:33409 Fax: 561-478-4100
E-Mail:tommyyork2014@att.netPhone No 561-712-9000
Fill In fee simple Title Holder on next page(If different E-Mailpermits-wpb@newsouthwindow.com
from the Owner listed above) State or County License CRC1330822
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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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SUPPLEMENTAL CON STRUCTION2 LIEN:LAW I.N;FORMATION ' i
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:
Ad d cess: 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 certifythat no work or installation has commenced priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohlbltisuch
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 exemptfrom undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
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"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 SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANaNG, CONSULT
WITH YOUR LENDER OR AN AT-FORNEY BEFORE RECORDING YOUR NOTICE OF VPMFPENCEHENT."
Signature of Owne./ essee/Co actor as Agent for Owner Signature of Contractor/ cense Holder
STATE OF FLO l� STATE OF FLO
COUNTY OF Q\(Y1 C�/1 COUNTY OF�XYX �, a&N
The forgoing instrume t as acknowled before me The f ing instrument as acknowledged before me
this day of _�,20�� by this day of QC Cr 26 by
eL — -
Name of person m king st tement. Name of person making statement.
Personally Known OR Produced Identification Personally Known Z�_OR Produced Identification
Type of Identificationnn Type of Identification
Produced JFL� Produced
_ ..i J \
{Si nature of ItotaryPublic-St n ur of to lic-Sta
�������,, PHILIP G. PER T g N
\��ogYP�e'% reS9Y°ern Notary Public State of Flo id
11pp 1�`r�j %-State of Florida-Notar btic
Commission OO"47 _ `�$ejmmission # GG 1 t Sion NO�� 1 70 (S�g1 ifer Dubie'n
?n A� My Commission E Cres - , MyCommisson''GG 179700
9- 1;"OQ' Expires 01/28/2022
December 10, 2 21
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev.2/7/19
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