HomeMy WebLinkAboutBuilding Permit Application .,d APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �ol•'`�' o � �� Permit Number: y
Building Permit Applicatlorf
Planning and Development Services •'
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-2553 Fax:(772)462-1578 Commercial x, Residential
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PERMIT TYPE:WIN DOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 10044 S OCEAN DR 1004 Jensen Beach,FL 34957
Property Tax ID#: 4502-804-0076-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Morrison
DETAILED DESCRIPTION OF WORK:
REPLACE ENTRY DOOR WITH IMPACT.
USING LIKE SIZES,NO STRUCTURAL CHANGES BEING MADE.
JOB UNDER$2500 NO NOC REQUIRED
FCONST INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank Gas Piping Y Shutters ;Windows/Doors
_Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1928 Utilities: —Sewer —Septic Building Height:
OWNERf LESSEE: CONTRACTOR:
Name Richmond W&Susan T Morrison Name:BRUCE M.TYRRELL,JR
Address:10044 S Ocean DR Apt 1004 Company:KAMRELL WINDOWS&DOORS
City: JENSEN BEACH State: Address:2201 SE INDIAN ST BLDG Q-4
Zip Code: 34957 Fax: City: STUART State:FL
Phone No.772-229-7677 Zip Code: 34997 Fax: 772-288-6208
E-Mail:RICKSUE1953@COMCAST.NET Phone No 772-288-6205
Fill in fee simple Title Bolder on next page(if different E-Mail ADMIN@KAMRELL.COM
from the Owner listed above) State or County License CGCO61180
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _Not Applicable j
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 permitmill 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."
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Sig ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Lice a Holder
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STATE OF FLORIDA STATE OF FLORID ii
COUNTY OF ice.d � COUNTY OF Cl(Tt n
The forgoing instru was acl nowledged before me The forgoing instrument was acknowledged before me
this Jnay of 2090 by this Ji0day of 20by
'c.hnr�n h wdT�l' s��n use M
Name of person making statement. Name of person making stoma ement.
Personally Known OR Produced Identification �� Personally Known !- OR Produced Identification
Type of IdentifiqAtionType of Identification
Produced rL. L_ Produced
(Signature of Not . ���= — — �� :: (Signature of Not P ,Ii�t:Stat&o�Flei�
SUSAN M GODDARD ' SUSAN M �DAHD
r d�"Y�PV to 1 Florida
Commission No. f Notary P(g�py State of Florida � Commission N .•'o�D� °��•. Notary Public- 3219
Commission#GG 033219 . Commission 25.2020
;�, My Comm.Ex Ires Se 25 2n '' Comm.Expires Sep
Bonded through Na ional Notary Ass^ s' '°••;}soap•`•, dedlhrou
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