HomeMy WebLinkAboutApplication 8652 Clearlake Ln windowsAll APPLICABLE INFO? MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 452-1578 COI711'i'lercial Residential
PERMIT TYPE:.�I�Acr �1�lIN�OVJS l�CC�i�b�ObJ �j1-4JT[ERS
PROPOSED IMPROVEMENT LOCATION:
Address: &,gy5M1.r l.Y.GLr MXt L. w\t k-1. IJMQ� o H -54M,,fi1
Property Tax ID #: l 0034' 000
Site Plan Name: 1lvil kt• E TITES
Project Name: I • 6won,
Lot No. 30
Block No.
1 DETAILED DESCRIPTION OF WORK: !
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping V Shutters
— Electric _ Plumbing _ Sprinklers ___. Generator
Total Sq. Ft of Construction: Sq. Ft. of first Floor: _
O
Cost of Construction: S 11=0 Utilities: _ Sewer _ Septic Building Height:
V Windows/Doors
Roof Pitch
OWNERILESSEE:
CONTRACTOR:
NamertA &OW11A
Name: 5eA.R. wz441
I Address: LEA•. E_ WE
Company: G'EW! tLE. COi2IO
Address: 31W -FURTLE CZVE.
City: W P 6 ii State:
city:
Zip Code: f 6 1 Fax:
Phone No rr--
E -Mail i i4 G GOYVt ACT -
E City: State: _
Zip Code: _Nil Fax:
Phone No. 'I -72j- V6 _044(o
E -Mail:
Fill in fee simple Title Holder on neat page ( if different
from the Owner listed above)
State or County License (.
I W 113 I 11
If value of construction is $2500 or more, a RECORDED Notice or Lommencemeni is requlrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
SIGNER/ENGINEER: _ Not ApplicableRTGAGE
NamName.
Address:
COMPANY: _ Not Applicable
Address:
City: State:
Zip: ne
City: State:
Zip: Ph
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 thepermit 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."
Rev. 2/7/19
'P'" �y� Notary Public State of Florida
Marybell Martinez ^,^�,
Signatur bf Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/ 'cense Holder
STATE OF FLORIDA -4,
COUNTY OF ' Q C�[
STATE OF FLORI y-�,
5S,&,C.H
I- �
COUNTY OF 1 [�1-M
The f oing i str, nent 1yas acknowledg d before me
this day '1 20 W by
The fo oing in tr e w s acknowledged before me
this day of ? 20 by
—
lqll0 42 °
*
y' V 2A VXA.
Name of pe on Makin atement.
Name of person making statement.
V1
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature o otary Public- State of -F Ida)
(Sign atur �f Not y P ic- tete ofr �c�riIa
ka otaryu is tat of Florida
/s
`h Marybell Martinez
Commission No Gp (Seal)
Commission No. • ` Mycommissior SG91I097s
\
f %C> of 7 5 9
A l l i � ar w Expires 10/24/2022
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19
'P'" �y� Notary Public State of Florida
Marybell Martinez ^,^�,