HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-11-19 Permit Number:
Building Permit Application
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: Window/Door
PROPOSED -IMPROVEMENT LOCATION:
Address: 5212 Pinetree Drive
Property Tax ID #: 3402-602-0175-000-9
Site Plan Name: Rosko
Project Name: Rosko
Lot No. 15 & 16
Block No. 5
Replacing 10 Windows and 2 Doors with Impact Rated Products: Horizontal Roller HR5510 NOA#17-0411.08;
Single Hung SH5500 NOA#17-0630.05; Sliding Glass Door SGD5570 NOA# 17.0420.06; French Door FD5555
NOA#18-1108.03
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 17,126.00
_ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name David & Cristina Rosko
Address: 5212 Pinetree Drive
City: Fort Pierce Stater
Zip Code: 34982 Fax:
Phone No. 772-216-8261
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Michael O'Donnell
Company: O'Donnell Impact Windows
Address: 1740 NW Federal Hwy
City: Stuart State:Fl
Zip Code: 34994 Fax:
Phone No 772-408-0200
E-Mail odonnelipermitting@gmail.com
State or County License ORC1331273
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.
DESIGNER/ENGINEER:
Not Applicable
MORTGAGE COMPANY:
Not plicable
Name:
Name:
_
Address:
Address:
City:
State:
City:
State:
Zip: Phone /
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING CO!:!!.
Applicable
Name: f
Name:
_Not
Address:
Address:
City:
City:
Zip: X Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby ma to obtain a permit to do the work and installation as indicated.
I cer 'fy that no work or installation has commenced prior to issuance of a permit.
Lucie County makes no representation that is granting a ermit will authorize the permit holder to build the subject structure
which is in contlict 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
/jl iS JfJ.
5ignbture of OwfT-er/ Lessee/Contractor as Agent for Owner
Signature of`Coor%License Holder
STATE OF FLORI A i (
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STATE OF FLO' i
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COUNTY OF,
The c�c bi'n inst. ment was a nowled ed efore me
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this'/j3 day of
The fo��
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this thisaadayof��'t��.ZO by
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Name of person making state t.
Name of person makking s� ment.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signatu<ri of Notary Public- State of Florida)
(Signatu of Notary Public- State of Florida )
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Commission NoY �sf%(st',�n �.>;_. (Seal)
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DATE
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DATE
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Rev. 2/7/19 vgrn1 i 41
Gomp1.OGG366562
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