HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 2 �"1 ! ! '�1 ZY
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Building Permit Application
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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 X
PERMITTYPE: Windows & Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 2008 NW Laurel Oak Lane, Saint Lucie County, FL 34990-8019
Property Tax ID #: 4425-605-0037-000-2 Lot No._
Site Plan Name: Burke Block No.
Project Name: Burke
DETAILED DESCRIPTION OF WORK:
Replacement of Windows & doors with Impact
CONSTRUCTION INFORMATION: -
Additional work to' be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 42,500 Utilities: _ Sewer _ Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Eileen Burke
Name: Jeffrey Walsh
Address:10 Dogwood Road
Company: Liberty Home Builders
City: Moorestown State: _
Address: 257 SE Monterey Road
1 Zip Code: 08057-3850 Fax: N/A
City: Stuart State: FL
Phone No.609-315-5499
Zip Code: 34994 Fax: 772-324-8578
Phone No 772-626-3179
E-Mail: N/A
Fill in fee simple Title Holder on next page (if different
E-Mail info@libertyimpactwindows.com
from the Owner listed above)
State or County License CGC 1504157
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION':
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:
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 COMMENCEME Y RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMME ME T MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU I E TO O TAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y R OTC COM ENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Own5___- 31griatureofto tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF �Ar
The fo_Lgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 17ov evA be C , 20A by this—Lday of 1001lerAI4 , 20-A by
It<�rl /3u(k e wa1s 6� --
Name of person making statement. Name of person makAng statement.
Personally Known OR Produced Identification _X_ Personally Known _ OR Produced Identification
Type of Ide tification Type of Identification
Produced 1yt r S 1-A C_&% S f Produced
(Signature of Notary ((PuBlic-S'fat im o _
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Commission No. OFF
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DATE
RECEIVED
DATE
COMPLETED
C. FORTIN /� J
Notary Public - State of( a of Notary Public- State
Commission # FF 99906 0
My Comm. Expires N v& ion No. all /fib
3onded through National otary Assn,
SUPERVISOR I PLANS I VEGETATION I S REV RILE
REVIEW REVIEW REVIEW
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Commission # F . 9908
My Comm. Expires o 3, 2019
9onded through Nation ary Assn,
MANGROVE
REVIEW