HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: `�13,b Permit Number: a�4 -d O
r
.
Building Permit Applic ti n ag&
Planning and Development Services P iP � t
Building and Code Regulation Division St, Lucie e CO U nt F
2300 Virginia Avenue,Fort Pierce FL 34982 Y� L
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Resl en la
PERMIT TYPE: Window
PROPOSED IN{PROVEMENT
Address: 10410 S Ocean Drive Unit 707
Property Tax ID#: 4511-514-0052-000-8 Lot No.
Site Plan Name: Island Club Unit 707 Block No.
Project Name: Island Club-Dostou
'DwETA{LED DESCRIPTION O'F WORK i'
Replacement of Impact Wind I \ D en 3
UCTION
CONSTRINFORMATION ;
f: .kit _1.
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: 1,452 Sq. Ft. of First Floor:
Cost of Construction:$ 3,800 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR.
t�
Name Mildred Dostou Name:Jeffrey Walsh
Address:25 Summit Road Company:Liberty Home Builders
City: Belmont State:Xh Address:257 SE Monterey Road
Zip Code: 02478 Fax: City: Stuart State:FL
Phone No. Zip Code: 34994 Fax: 772-324-8578
E-Mail: Phone No 772-444-7112
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 COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THEJ BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN A , ONSULT
WITH YOUR LE O TTORNEY BEFORE RECORDING YOUR NOTICE O COMMEN ME :'
�igna a of r/Lessee/Contractor as Agent for Owner Signature o ntractor/L nse Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ��{1,1'O1 dl COUNTY OF ffla f tz'o
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of O wle m e( ,20� by this_--I-_day of��t�y�(�20—L by
Name of person making statement. Name of person ma ng statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificatio
Pr uce Produced
��, ,��� ,�4 !...... C.FORTIN
torP(,e� C.FORTIN r°� e`4+•� Notary Public State of Fli Ida
(Signature of Notary Publi -St t _) Commission FF 8 9(}�ignIsure of Notary Public-St e r '") Commission 89)9
' •, Aa' My Comm.Expires Nov 19
";r P°:� My Comm.Expires Nov 2019
F OF FI� ad through National sn.
Commission No.F� ��j�9o10�' ,,�•(5ededthrough National Na ark sion No. tr 0 '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1