HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: d.0 Permit Number:
RECEIVED
JAN 0 12020
Building Permit Application
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT TYPE: Residential -
PROPQSED 11VIPRQVEMENTLOCATION:
Address: 8605 Lakeland Blvd. Fort Pierce, FL 34951
Property Tax ID#: 1301-609-0001-000-3 Lot No. 1
Site Plan Name: Lakewood Park Block No. 1
Project Name:
DETAILED DESCRIPTION OF WORK
Replace existing windows with impact. 4 Openings
CONSTRUCTI;QN.INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Zwindows/Doors
—Electric —Plumbing —Sprinklers —Generator —Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 4500 Utilities: —Sewer —Septic Building Height:
,OWN ER/LESS'EE:- CONTRACTOR;
Name Shipley,Scott Name:Ronald Kromhout
Address:8605 Lakeland Boulevard Company:Ronald Kromhout General Contractor, Inc.
City: Fort Pierce State:_ Address:4500 5th Place SW
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.772-293-1946 Zip Code: 32968 Fax:
E-Mail:scott.agdsupply@hotmail.com Phone No 772-473-4597
Fill in fee simple Title Holder on next page(if different E-Mail kromhoutron@gmail.com
from the Owner listed above) State or County License CGC 023856
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 fl`N'FOR(VIATIO'N
=4
DESIGNER/ENGINEER: x_Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: 7'—
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 Count 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Indian River COUNTY OF IndianRiver
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 16th day of December 20_ by this 16th day of December 20_ by
R O•��� a.
\,-v C m h oU Ronald Kromhout
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known xx OR Produced Identification
Type of Identification Type of Identification
Produced �- t�L Produced
S
.!'"'9C& CHERT .L. 13RUMIT
RAV 5(Signature of Notary Public-State of Flor EXPIRES Ab1Sil�atr2�0o otary Public-State of Florida}
(401)39&-0153 FlbrsdiNom �t _
Commission NO' S FF9769N (Seal)
YPU
DEANNA MARIE GIVENS f
GG 022023
L
� EXPIRE :December 16,2020
REVIEW •• QUTedThru R4N18�'de""0'rs PERVISOR PLANS VEGETATION SEATURTLE MANGROVE
"tEVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19