HomeMy WebLinkAboutBuilding Permit Application ALL:kliPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED qq
Date: Permit Number:
RECEIVED
Building Permit Application
Planning and Development Services JAN 2 2 2020
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie ounty, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resl entla
PERMIT APPLICATION FOR: Window/door
PRORQSPR.QVEMENT.LOCAT QN
Address: 6787 Dickinson TER Port St Lucie, FL 34952
Legal Description: OLEANDER PINES REPLAT BLK 1 LOT 136 (0.246 AC) (OR 3446-1424)
Property Tax ID#: 3415-706-0007-000-9 Lot No. 136
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left-Side:
DETAILED DESCRIPTION OF 1NO111 t
REPLACEMENT OF 18 WINDOWS (IMPACT)
"CONSTRUCTI(3N 'IN,FQR'MATI'ON s °
�_
Additional work to be er orme un er t ispermit—check a apply:
❑ L_—HVAC I Gas Tank Gas Piping _Shutters Windows Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 29900 Utilities:Sewer Septic Building Height:
OWNER%IESSEE;,;
�, ' E CONTRACTOR
a . a.
Name Peyman,Gail Name: Alphonse Campanelli
Address:6787 Dickinson TER Company: STORM TIGHT WINDOWS
City: Port St Lucie State: FL Address:
Zip Code: 34953 Fax: City: Deerfield Beach State:FL
Phone No.(772)480-9754 Zip Code: 33442 Fax: 754-227-7891
E-Mail: ISI Phone No. 954-320-7554
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: CRC046091
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL'CON5TRUCTIQNLIEN LAW"IN FQyRMATCdN '
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Peyman,Gail Name:Alphonse Campanelli
Address:6787 Dickinson TER Port St Lucie,FL 34952 Address: 6787 Dickinson TER
City: Port St Lucie State: FL City: Deerfield Beach State: FL
Zip: Phone Zip: 33442 Phone:561.420.0271
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 the jobsite
before the•first inspection. If you intend to obtain financing, consult with lender or an attorney before
cornmencing work or recording our Notice of Commencement.
Signature of Owner/ a see/Contractor as Agent for Owner —Sig_n_atLFe of Contractor/Lice a Holder
STATE OF FLOrr � STATE OF FLORID
COUNTY OF l.fA-c- COUNTY OF �� I V (_'t
The forgoing instrument was acknowledg before me The r oing instrument was acknowledged before me
this ay of CTCi� 20 by this day of Of Dh�R� ,20L-by
Atelryir6c
Name of pers n making statement Name of pers makingstatement
Personally Known OR Produced Identification v` Personally Known OR Produced Identification
Type of IdenT�' ' a Ion Type of Identifica
— -
-Prod uced—t - Produced
(Signature of Notary Public-State of FlM ignc `ofary uffic-State of Florida)
;o� �Bi' ANTON RECHE o"t�YP�B,, VEREDWEINSTOCK
=�a o4s
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Commission No. (� * Notary Public - �� I ��( �� * ° e� mmisslon#GG 1781 7
N •x z= Commissic� #FF 920338
-,9Fn�K�oQo,; 9j QeoK Expires January 23,202
My Comm.Ex fires Dec 11,2019 �aFlLc BondodThraDWoulNoteryr�eni se
REVIEWS; FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17