HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: X2/2 /20 Permit Number: Z102r M85
FFEB
EIVED
- --- Building Permit Applicatio2 4 2020
Planning and DevelopmentServices
Building and Code Regulation Division unty, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMITTYPE: Window / Door Replacement y
PROPOSED IMPROVEMENT LOCATION:
Address: 10200 S Ocean Dr#204,Jensen Beach FL
Property Tax ID#: 4511-518-0012-000-8 Lot No.
Site Plan Name: Atlantis III By The Sea Block No.
Project Name: Baranowski Residence
DETAILED DESCRIPTION OF WORK:
Remove and replace windows and doors.
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:$ Si 30D Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name David Baranowski Name:[?avid LaPrade
Address: 103 Squires Rd Company: The Glass Professionals
City: Madison State: Address:3570 SE Dixie Hwy
Zip Code: 06443 Fax: City: Stuart State:Fl
Phone No.203-376-4004 Zip Code: 34997 Fax: 772-286-0461
E-Mail: Phone N0772-286-0459
Fill in fee simple Title Holder on'next page(if different E-Mail permits.glasspros@gmail.com
from the Owner listed above) State or County License 19363
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
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_91121ROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED E TE B RE THE FIRST INSPECTION. IF INTEND OBTAIN FINANCING, CONSULT
WITH Y R L DER ATT NEY BEFORE RECORDING YO)OR TIC CQr IMENCEMENT."
Signat e o Owner essee/ ontractor as Agent for Owner Signatu of Contractor is Ho
STATE OF F1QRIg � ) COUNTY OFSTATE OF (,
COUNTY OF N�u�j11
The fr ing instr ent was acknowledg d before me The forgoing instr ent was acknowledged before me
thisday of fttlf U& 20 by this day of 20 by
VOW La frail& i?ow►d lit, r",c,
Name of person making statement. Name of person making statement.
Personally Known / OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
ima V I PAN= - AM64=
(Signature of NottNotaryPuubllii,-State of Florida) (Signature of Notary Public-Sta of Florida)
Commission No.% 34DA (Seal) Commission No.6 G234(7Q (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. e;
"pG BRENDALOPER Qin/?�9Lc BRENDALOPER
MY COMMISSION#GG 234007 MY COMMISSION#GG 234007
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EXPIRES:July 1,2022EXPIRES:Jul 1,2022
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