HomeMy WebLinkAboutBuilding Permit Application 1 '
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ALL APPLIC BLE I IFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ Permit Number: .4_.'U0I.'o0 1
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- RECEIVE-0
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Building Permit Application
Planning and Development Services JAN 1 3 2019
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Resid
PERMIT APPLICATION FOR: Wridow/door
PR®P®SEDIMPR®uEIVf,ENT _ _. 4.� " � .. KIM,,
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LOCAL
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Address: 10707 Okeechobee Rd, Fort Pierce, FL 34945
Legal Description: HATTIECHAMBERLIN SID IN 2835-39 THAT PART OFTRACT 7 LYG NLY OF CANAL 57-%{ESB BEG AT Fr OF INT OFSLY RNYOKEE RD AND WU TRACT7,TH NELY ON SO R/WM2.5Fr.TH SLY 225 FT,TH SWLY//WRHRDRAN202.5Fr-
TH NLY 225 FT TO POB-AND W 166.7 FT OF TRACT 8 LYGNLY OF CANAL 51-X-LESS RD RAN-(3.75 AC)(OR 259-1155:260-813)
Property Tax ID#: 2328-501-0012-000-8 Lot No.
Site Plan Name: /� Block No.
Project Name: .:0 010V
Setbacks Front Back: Right Side: Left Side:
Gam. ,�as'i WNW N OF WgyRSK.
REPLACEMENT OF 4WINDOWS and 3 Doors (IMPACT)
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C®NST � . Pffiil all,
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Additional work to be nerformed under this permit—check all that appy:
HVAC Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 50283 Utilities:Sewer Septic Building Height:
OUVNE�R LESSEE f � fCONTRACTR ��� _ �
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Name Nancy Skinner Jacobs Name: Alphonse Campanelli
Address:PO Box 1172 Company: STORM TIGHT WINDOWS
City: Fort Pierce State: FL Address: 500 SW 12 Avenue
Zip Code: 34954 Fax: - City: Deerfield Beach State:FL
Phone No.(912)424-0794 Zip Code: 33442 Fax:
E-Mail: Phone No. 561-420-0471
Fill in fee simple Title Holder 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.
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SaURPLEMENTAICONSTRUCTION LIEN LAW iNFOR11/IATiON
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DESIGNERANGINEER:-- "`"Not Applicable MORTGAGE COMPANY: MNat-Applicable''
Na m e:Nancy Skinner Jacobs N a me:Alphonse Campaneili
Address:10707 Okeechobee Rd,Fort Pierce,FL 34945 Address: PO Box 1172
City; Fort Pierce $tate: FL City; Deerfield Beach State; FL='
Tip: Phone :: s` x"''` Z►p:.3344z = ane:561.420.0271 „
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY:, `NotAppiicakile;4 -
Name: Name:
Address:500 SW 12 Avenue _ :Address:
City: City:.
Phone, zip:-. -. - __Phone-.,_. ._. -
"OWNER/,'CONTRACTOR AFFIDVIT:Application is-,hereby made to obtairi a permit to_do the work-and instaliation'as.indicated.
I..certify that no work.or.installklon.has commenced,.i for to the issuance of a permit:`:r __ __ `'. ''`` _
Stjucie.Coun y_makes no representation that-is granting a pmit.
ermit will authari e the,pe'rh`older to pu`i!d the subject 'structure ..'
which is in conflict with any applicable Home at,
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 p}ans,'the Florida Building Godes and St.Lucie County Amendments.
The-following.bdilding permit applications.are exempt from undergoing a full.concurrencyreview;`room:addit ons,
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 r-ecorded..and posted on-the jobsite'_..
before the first inspection. If you intend to obtain financing, consult with lender,or an attorneybefore
commencing work or recording-your Notice of Commencement.
Signature of ner/Lessee/Con or as Agent for Owner Signature of Contractor/License.Halder ; T
STATE OF FLORIDA ATE OF FLORIDA - N
COUNTY OF L e LINTY OF . L.
The-forgoing instrument was acknowledged before ,e forgoing instrument,was acknowledged,before,me w a
this day of 2G.. 2Q by., t - .� s �` day of b2 c 2011--6y
aVt
Nalne of person making'statement g" Namesof-person making atementEf
P.ersonally,Known OR Produced Identifica; int .� rsonally;Knawn ' OR Produced identificatio:11n
Type of Ident'ificafion o pe of Identification z
Produced z CS oduced
(Signature of Nota lic-State of Florida)' i .� Signature of Notary Publi - tate of.Florida
Commission No: (Seal) ommission No. - -' (Seal}
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE`'`
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW-
REVIEW.:
DATE r
RECEIVED
DATE -
COMPLETED
Rev.8/2/17