HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11A�-AA Permit Number: CSC)
0 RECEIVED
Building Permit Applicat on JAN 8
Planning and Development Services
Building and Code Regulation Division �T, LlIc10�pUnl,P�rICf rtg
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:Window replacement
F=ROPOSEDFIMPROVEMENT LOCATISON
Address: 13607 S Indian River Dr. Jensen, Beach FL. 34957
Property Tax ID#: 4509-801-0009-110-0 Lot No.(OR 3757-1493)
Site Plan Name: NIA Block No.
Project Name: Window Replacement
rJkl
DETAILED-DESCRIPQFTION WORK
, ,
R/R (6)windows on the second floor.Windows will be PGT Impact window
:CONSTRUCTION INFORMATION ,
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:$ 4,000.00 Utilities: —Sewer —Septic Building Height:
OWNER LESSEE CONTRACTOR
=h
NameStephanie Hubbard Name:Earl Gaines
Address:13607 S Indian River Dr. Company:E &B Elite Services Inc.
City: Jensen Beach State:_ Address:5821 Starcher Ave
Zip Code: 34957 Fax: City: Ft. Pierce State:FL.
Phone No.772-285-5865 Zip Code: 34947 Fax: 772-465-2351
E-Mail: Phone No772-577-0826
Fill in fee simple Title Holder on next page( if different E-Mail ERLGAINES@COMCAST.NET
from the Owner listed above) State or County License CGC1 517445
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. .
Sul
ALt
PPLEMENTCONSTRUCTIO LInEN
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: of Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: L.Xot Applicable BONDING COMPANY: 4-rMot 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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or an9covenants 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-5-"V. COUNTY OF k. N.,,a r-
The f rgoing instrument was acknowledged before me Theoing instrument was acknowledged before me
this day of 'Qt 20by thisfz day of 7Jfkfl-, 20-k-n by
YN
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced b L,
(Signature of Notary Public-State of Florida) (Signature of NotaUWM'§
y tAISSION#GG 022023
mev__ # G 0 rj?3 ommission No S:Demo
Commission No(., '-,m =M1 �aat)2020
Go Underwriters
S. Bonded Thru Notary Public Un
0.1 niber 16,20240
ublicUtide
5,nde
REVIEWS FRON 'SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev.