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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: n�- 0 1(D
RECEIVED
FER 0 6 2020
Building Permit Application Permitting Department
Planning and Development Services St. Lucie Countv
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XXX
PERMITTYPE: Exterior Door Replacement
PRO'POSED,IMPROVEME'NT LOCATION:
Address: 5103 Indian Bend Ln
Property Tax ID#: 1312-800-0019-000-3 Lot No.
Site Plan Name: Albert & Gale Parmentier Block No.
Project Name: Albert & Gale Parmentier
DETAILED DESCRIPTION;OF WORK:, '
Replace 72" x 80" Exterior Door
CONSTRUCTION.INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ / SJ�3.00 Utilities: —Sewer —Septic Building Height:
:OWNER/LESSEE: CONTRACTOR:,`
Name Albert & Gale Parmentier Name: Adam A Ogilvie
Address: 5103 Indian Bend Ln Company:Thompson's Remodeling & Home Repair, Inc.
city: Fort Pierce, FI State:_ Address:P.O. Box 430
Zip Code: 34951 Fax: city: Vero Beach State:FI
Phone No.772-979-2543 Zip Code: 32961 Fax: 772-564-6760
E-Mail: Phone No772-564-8008
Fill in fee simple Title Holder on next page(if different E-Mail michelle@thompsonsremodeling.com
from the Owner listed above) State or County License CGC1 528411
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.
� NE—MEN MM,GOD NdS�TRUCTIONIrLIrE�N�)L'�A�1N�IIIVFO��IVI"A�TI®�N'
DESIGNER/ENGINEER: XXX Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: I
Address: Address:. i
City' State: City: State:
Zip: Phone Zip: Phone: I
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City: _
Zip: Phone: Zlp: Phone:
OWNER/:CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as Indicated. I
I certify that no work or installation has commenced prior to the issuance of a permit.
I
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 j
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE-OFCOMMENCEMENT." 1
f/
Signature of Owner/Lessee/ConXor as Agent for Owner Signature of Contractor/ cense Holder
STATE OF FLORIDA STATE OF FLORIDA1
COUNTY OF COUNTY OF
The forgoing instrument Was acknowledged before me The forgoing instrument was acknowledged before me
this_day of 20_ by this 'I--day of,0-,6ry h.., 202o by !
I
` 1
Name of person making statement. Name of person ma ng statement.
Personally Known OR Produced Identification Personally Known Z OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (S gn ture of ar
Commission No. Seal Commission No.
a" EXPIRES:December 18,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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