HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO cMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application,,.
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Planning-a d'. velopment Services S ! N 6?�
Y.,lam' /�; Permitt. 19
Buil&i ' d//�e Regulation Division ng
2300 Virgitf(a. venue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT TYPE:WINDOW/DOOR INSTALLATION
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Address: 9940 S OCEAN DR 809, JENSEN BEACH
Property Tax ID#: 4502-502-0086-000-0 Lot No.
Site Plan Name: Block No.
Project Name: ROLON
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REPLACE 2 SLIDING GLASS DOORS WITH NON-IMPACT USING EXISTING ACCORDION SHUTTERS
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 16,400.00 Utilities: —Sewer —Septic Building Height: IL-I IL-I0
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Name Michelle M Rolon Name:BRUCE M.TYRRELL,JR
Address:17290 SW 276th ST Company:KAMRELL WINDOWS & DOORS
City: Homestead State:_ Address:2201 SE INDIAN ST BLDG Q-4
Zip Code: 33031 Fax: City: STUART State:FL
Phone No.786-200-8097 Zip Code: 34997 Fax: 772-288-6208
E-Mail:MICHELLEROLON@ATT.NET Phone No 772-288-6205
Fill in fee simple Title Holder on next page(if different E-Mail ADMIN@KAMRELL.COM
from the Owner listed above) State or County License CGC061180
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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l:1PPL=MENCfII�STR J CTIONIIEN LAWIF „RNI
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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 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 FINANCING, CONSULT
TH KOUR LENDER OJR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner Lessee/Contractor as Agent for Owner S gnature of Contractor/Lice a Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF n
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
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this day of"OZ,; E1R ,201 q by this 3rd- day of 10 ea? ber ,20_1�by
Name of person making statement. Name of person making statement.
Personally Known- OF;Produced Identification H -Personalty KnownProduced Identification
Type of Identification Type of Identification
Produced eL U b'12 4 vZ Produced
gnature of ftTary lic-State of Flori Ken King (Signature of Nota
NOTARY PUE IUCSUSAN M GODDARD h
Commission No.�p��3f� 7 STATE OFF r n .o Notary Puq�;aI�ate of Florida
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Comrr GO0 07 •_
commis ion GG 033219
sN E 0 E fires 11/ 2A20 My Comm.Expires Sep 25,2020
'• „„ Bonded through a i
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA U T ANGROVE "
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19