HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \ `�1 Permit Number:M11= Is a
RECEID
Building Permit Applica ion JAN 0 9
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Window/door
PROPOSEDz,IIVIPROUEMENT LOCATION: r� F �x_�.t..
Address: 5148 Cherry Palm Way, Fort Pierce, FL 34981
Legal Description: RIVER BRANCH ESTATES LOT 4 (0.50AC) (OR 3855-1540;4123-1524)
Property Tax ID#:�4 Cly - - n -2) Lot No.4
Site Plan Name: } Block No.
Project Name: )V(\o'A
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF'.WORK:
REPLACEMENT OF 16 WINDOWS (IMPACT)
CO NSTR'UCTION,1NFORMATION: ,
Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 30493 Lltilities:n Sewer Septic Building Height:
;OW:NE,R/LESSEE:_ CONTRACTOR:
Name Samerah Razuman Name: Alphonse Campanelli
Address:5148 Cherry Palm Way Company: STORM TIGHT WINDOWS
City: Fort Pierce State: FL Address: 500 SW 12 Ave
Zip Code: 34981 Fax: City: Deerfield Beach State:FL
Phone No.772.332.9350 Zip Code: 33442 Fax:
E-Mail: Phone No. 561-420-0471
Fill in fee simple Title H Ider on next page(if different E-Mail: stormtightpermits@outlook.com
from the Owner listed above) State or County License: CRC-046-091
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
A SUP"PpP
`LEMENTAL CON�STRUCTIO,N L`IEN`LAW IN=FORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Samerah Ramman Name:Alphonse Campanelli
Address:5148 Cherry Palm Way,Fort Pierce,FL 34981 Address: 5148 Cherry Palm Way
City: Fort Pierce State: City: Deerfield Beach State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:500 SW 12 Ave 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 the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
r
— la
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOW6 STATE OF FLORIDA l
COUNTY OF Iln`� UTA�� COUNTY OF �
The forgoing instr ment wa acknowledged before me The forgoing instrument was acknowledged before me
this. day ofd G2.6r ,26Z9 by this R1n day of rN�'Q_C' .20_a by
mpml-) PrA7.(A-qW(, a1R-n)V_ ' Pan Nth
Name of per;pvInaking statement Name of per on making state ent
Personally Known OR Produced Identification Personally Known 7 OR Produced Identification
Type of Identification Type of Identification
Produced '�L Produced
(Signatu a of Notary Public-State of Florida) (Signature of'NN lic-StatAwhi
Commission N Y.,gHN(SgERT Commission
•z MY COMMISSION 8 GG068165 SOMW Tft<A♦11011 N0hn
EXPIRES February 19,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17