HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: [q1z.
Ol
Building Permit Application
Planning and Development Services
Building and'Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 3252 Lakeshore Dr, Fort Pierce, FL 34949
Property Tax ID #:1425-676-0014-000-6 Lot No.
Site Plan Name:
Project Name: John &
Tice
DETAILED DESCRIPTION OF WORK:
Replacement 1QWindows and 2 Doors
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
—Mechanical _Gas Tank _Gas Piping _Shutters
Electric —Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 22,400
_ Generator
Sq. Ft. of First Floor:
Block No.
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJohn & Mary Tice
Name: Steve Lambert
Company: Newsouth Window Solutions
Address:3252 Lakeshore Dr
Cry. Fort, Pierce State: FL
Address:2526 Okeechobee Blvd.
Zip Code: 34949 Fax:
City: Vest Palm Beach State:FL
Phone No.(772)801-5135
Zip Code: 33409 Fax: 561-478-4100
Phone No 561-712-9000
E-Mail: jttice@gmail.com
Fill in fee simple Title Holder on next page ( if different
E-Mailwestpalmbeach@newsouthwindow.com
from the Owner listed above)
State or County License SCC131151763
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Add ress:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
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! nstallation 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 covenantsthat 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: buiIdling 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
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTIICE 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 TOO THIN FINANCING, CONSULT
WFFH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMENCEMENT.7 -
Signatureo wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
-STATE OF FLO DA
STATE OF FLORIDA
COUNTY OF M_1)9Q
COUNTY OF PbLkrr+ Pxs2 do
The for oinstrument was acknowledged before me
The forgoing instrument wa acknowledged,before me
Hing
ti day of N� r%'be tr , 20� by
this � day of C 20LY by
Name -of on making statement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known _ , OR Produced Identification
Type of Identification
Type of Identification
Produced FL
Produced
_
LZ
ure rocittary Public- State o F10d
{Sign ure of No ry Public- State of Florida
,p��QeHtLIP G. PER
Commission No. `=�P Y' °' { e of Florida-Notar,
TT }
sion No. I -1 ��. ��A S2Tfer Dubiene of Flori
o
_. •_ 'Commission # GG 1
E,
65 c My Commission GG 17970
Aires
M Commissiorr
+. .: Q Expires 01 /2e12022
�.;1111% %
DecernDer
REVIEWS
FRONT
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Kev. 2177 19