HomeMy WebLinkAboutBuilding Permit Applicaiton ' I
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PPLICABLE INFO MUST BE COMPLETED.FOR.APPLICATION-TO BE ACCEPTED
e: D Permit Number:
69
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Building Permit A Iication ` X01®
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Planning and Development Services C°�%fie
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:Retrofit Windows
PROPOSED IMPROVEMENT,LOCATION;
Address: 140 Dominion Court, Hutchinson Island, FL
Property Tax ID#: 1414-7010122-010-0 Lot No.L
Site Plan Name: Karlsson QUEENS COVE-UNIT 1 BLK 13 LOT L Block No. 13
Project Name: Marilia Karlsson
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DETAILED'DESCRIPTION OF'WORK:
Retrofit and total of 12 windows and 1 door with Impact
77-
CONSTRUCTION INFORMAT{ON:
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters X Windows/Doors
_Electric _Plumbing _Sprinklers ;Generator „Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 15,435.44 Utilities: —Sewer _Septic Building Height: 15 ft
OVIINER/LESSEIECONTRACTOR
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Name Marilia Karlsson Name:Sam Weller
Address: 160 Dominion Court, Hutchinson Island, FL Company: Gulfstream Windows&Sliding Doors
City: Hutchinson Island State: FL Address:831 SE 1st Way
Zip Code: 34949 Fax: city: Deerfield Beach State:FL
Phone No.561-685-1459 Zip Code: 33442 Fax: 954-421-8499
E-Mail: mkarisson(a-)copperlinepartners.com Phone No 954-421-0390
Fill in fee simple Title Holder on next page(if different E-Mail henry@gulfstreamwindows.com
from the Owner listed above) State or County License CGC1524645
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.
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SUPPLEMENTAL CONSTRU ISN LIEN, LAIN INFORMATION: : -T
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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 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."
S t e of Owner/Lessee/Contractor as Agent for Owner Signa re of Contractor/Licens older
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STATE OF FL QRIDASTATE OF FLORID
COUNTY OF PA ,-1)ZNCAX COUNTY OF �iroward
The.forgoing instrument was acknowledged before me The forgoing instrupent was acknowledged before me
this 3� day of ,Aw�RR't .20ao b c this 3 I day of J(X✓1 u C+r� ,20x0 by
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Name of person making statement. � # f Name of person making statement.
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Personally Known�_OR Produced Identi icotim iz Personally Known y OR Produced Identification
Type of Identification < ;' vB Type of Identification
Produce Z X Produced
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(Signature of otary Public-State of Florida} (Signature of Public- a c-Stof id
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Commission No. (Seal) Commission No.GC q(q900 � e e�o•u�mrrswrloe,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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