HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date; �• I �•Z�J (J Permit Number:
RECEIVED
Building Permit Application MAR 17 2020
Planning and Development Services ST..Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34.982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
'PROPOSED IMPROVEMENT LOCATION:.
Address: 6 Los Lagos Ln,Port St Lucie,FL 34952
Property Tax ID#:3427-500-0403-000-0 Lot No.��
Site Plan Name: Block No.
Project Name: Delores Niesolowski
DETAILED DESCRIPTION OF WORK:
Replacement 4 Windows
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:$7,569 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameDelores Niesolowski Name:Steve Lambert
Address:6 Los Lagos Ln Company:Newsouth Window Solutions
City: Port St Lucie State:FL Address:2526 Okeechobee Blvd.
Zip Code: 34952 Fax: City:West Palm Beach State:FL
Phone No.772-249-5467 Zip Code: 33409 Fax: 561-478-4100
E-Mail: Phone No 561-712-9000
Fill in fee simple-Title Halder on next page(if different E-Mailwestpalmbeach@newsouthwindow.com
from the OwneiJistei above) State or County License SCC131151763
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.
a
SUPPLEMENTAL CONSTRUCTION' LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Add ress: Add ress:
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 certifythat no work or installation has commenced priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto 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 exemptfrom undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessoy 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 FINANaNG, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OFLMOENCEMENT.w
Signature of Owner/Lesse /Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOWPA, STATE OF FLO
COUNTY OF- 1/( In Q on COUNTY OF Mr—% �C�1
The going instru ent was acknowledged before me The fo oing instrument was acknowledged before me
this'day of _,26X by th is y day of ) I c�rC.PA ,20�by
Y g�cv-'e P_`.3?(Cw7':l•S S��f�1r,2rn L�y' _,[4-
Name of person making statement. Name of pe on making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(signature of Notary Pu - a.e,of FIcR1db I
1P"Y P"e�;State of Florida-Notary Publi S n ure Notary Public-State of Florid
Commission No.G K •_ Co mi Sion # GG 166547 F'al�
otary Publi - to of Floric
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