HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: •��•�� Permit Number:
Building Permit Application
Planning and Development Services RECEIVED
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 JAN 2 3 2020
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re clential X
ST. Lucie County, PermiWng
PERMIT APPLICATION FOR: Window/door
-PROPOSED IMPROVEMENT LOCATION:
Address: 5000 Fort Pierce Blvd., Fort Pierce, FL 34951
Legal Description: Lakewood Park Unit 1 Blk 6 Lot 1
Property Tax ID#: 1301 601 0077 000 2 Lot No.1
Site Plan Name: Block No. 6
Project Name: Randall Hirschfeld
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONIOF WORK:
taco 2-
CONSTRUCTION
CONSTRUCTION INFORMATION:e
Additional work to be nprtormed under this permit—check all appy:
HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 1 S . Ft. of First Floor:
Q
Cost of Construction:$ 1 t `� 1 Utilities:Cn Sewer OSeptic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name Randall Hirschfeld Name:"6� (r •-rn[..�
Address:5000 Fort Pierce Blvd Company: Florida Window and Door
City: Fort Pierce State:_ Address: 1125 N Dixie Highway
Zip Code: 34951 Fax: City: Lake Worth State:FL
Phone No.772-579-2180 Zip Code: 33460 Fax: 561-624-8037
E-Mail:rhirschfeld2003@yahoo.com Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different E-Mail: Howard@floridawindowanddoor.com
from the Owner listed above) State or County License: CGC-1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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.w4ark or recording our Notice of Commencement.
_ s
Signat a of Owner/Lessee/Contracto as'Agent for Owner Signature of Contractof?ff&Me1Tof er
STATE OF FLO ID LAW
STATE OF FLORID�COUNTY'OF �I'l�l(it�� COUNTY OF &C1,
Ther oing instru(nent was.ackno`wledged before me The for oing instrul ent was acknowledged before me
this day of .20'kDby this day of 202_by
Randall HirschfeldL Scott Berman
(Name of person acknowledging (Name of person acknowledging)
nature of Notary Public-State of Florida) / (Signature ofVotary Public-State of Florida)
Personally Known OR Produced Il�?tification t/ Personally Known OR Produced Identification
Type of Identification Produced V��L Type of Identification Produced
Commission No.
2 w hae,Cha on Anglin Commission No. (Sea[
NOT UBLIC
flA'I
STATE OF FLORIDA Notary Public State of Ftorida
.<^>,.g r c My Commission GG 343472
Revised 07/15/2014 Expires 10/14'/2022 9�oi��s Expires 07/09/2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS