HomeMy WebLinkAboutBuilding Permit Application i
ALL AP,�CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED rnrn
Date: Permit Number:
ar n n ye RFcelveD
• ._.. 7.019
Building Permit Application
olltPlanning and Development Services perm,rtin9 coup yent
Building and Code%Regulation Division Ducie
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED INLPROVEMENT LOCATION
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Address: 10152 S OCEAN DR 113B
Legal Description: ATLANTIS CONDOMINIUM BLDG B UNIT113B AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 3980-1198)
Property Tax ID#: 4502-803-0003-000-9 Lot No.
Site Plan Name: Block No.
Project Na:me:,Gonzalez-1075
Setbacks'-1 Front.. Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Window, replaceTerA.size for size 3 w' N-PC)CV
-V PC,C--r U,, it WLvs
CONSTRUCTION INFORMATION
Additional wor K to be nertormed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
0 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
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Cost of Construction: $ t20 = Utilities:Sewer E]Septic Building Height:
OWNER/LESSrEECONTRACTOR
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Name Daisy Q Gonzalez-Colli Daniel Millan Adoracion P Millan Name: Mark Collins
Address:213 Reading AVE Company: Window World of West Palm Beach
City: Titusville. State:FL Address: 1500 N. Florida Mango Road, Suite!16B
Zip Code: 32796 Fax: City: West Palm Beach State:FL
Phone No.`.., Zip Code: 33409 Fax: (561)684-2050
E-Mail:-':. Phone No. (561)684-2040
Fill in fee.simple Title Holder on next page(if different E-Mail: westpalmbeach@windowworld.com
from the;.'Owner listed above) State or County License: CBC1260052
If value of construction is$12500 or more,a RECORDED Notice of Commencement is required.
5'VPPLEMENTA,L,CONSTRU.CTION LIEN LAW INF,QRMATION; . �=",,
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name:- Name:
Address;::'.-., Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that rro work or installation has commenced prior to the issuance of a permit.
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St. Lucie Countyy 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
WARNIN NER:Your failure to Record a Notice of Commencementmay result in your paying twice for
impr ments t your pr rty. A otice of Commencement be r corded an on the jobsite
be re t
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rasp on. 1 ' end to obtain financing, a .n t h lend r an atto ney before 1
m encir rec din Notice of Commenc�rft-nt.
s
ignature of 0 ner/Lessee/Agent j ature of Con ac I older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Beach COUNTY OF Palma...h
The forgoing.,instr en as acknowledged before me The forgoing instru ent was acknowledged before me
thisday.of 201by this /S day of G.fk-✓ 20/�by
Mark Collins l Mark Collins
(Name of;person'acknowled g•In
g) (Name of person acknowledgi
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M.PFRR ff � M.PFR ffie`�
(Signat re o Nto Public ate of brida•b� X27? �•••• �� (Signature t Public-State o a).•0� �27:2 %�•. '�
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Personally Known x OR Prodaed identification�# Personally Kno x OR Producaa Id�ntificat�icna :
Type of Identification Produced = k : Type of Identification Produced *: Rw?VM7 ;
77� i O• ° B `0��•Off` i2•• ° 9 .0g•���
Commission No& `/7 I e%,'00ded�d �. i a�pu gcU�d�e '•�.°���
i y •.,• c un 0�• °��� Commission No.�G67�757
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IN11
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS L
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