HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
Building Permit Application
Planning and Development Servims
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 1701 S Brocksmith Rd, Ft Pierce, FL 34945
Property Tax ID $:2317-243-0010-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Arthur & Patricia Nelson
DETAILED DESCRIPTION OF WORK:
Replacement 8 Windows
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 12,900
Gas Piping
_Sprinklers
Shutters
Generator
Sq. Ft. of First Floor: _
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameArthur & Patricia Nelson
Name: Steve Lambert
Address:1701 S Brocksmith Rd
Company: Newsouth Window Solutions
City: Ft Pierce State: FL
Zip Code: 34945 Fax:
Phone No.772-359-3821
Address:2526 Okeechobee Blvd.
City: West Palm Beach State:FL
Zip Code:33409 Fax:561-478-4100
Phone No 561-712-9000
E-Mail:
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailwestpalmbeach@newsouthwindow.com
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 $7,5W or more, a RECORDED Notice of Commencement Is required.
SUPPI�tAI CNSTIi.
1#EPI
MACi+tl:
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
Not Applicable
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 the permit holderto build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or ang covenantsthat may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which mayapply.
In consideration of the granting of this requested permit, I do hereby agree that 1 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
O4TARMMG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENF MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYDIENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE RRST INSPECTION. IF YOU INTEND TO OBTAIN RNANONG, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMENCEMEWF."
signaturd4yrownelLas Agent for Owner
Signature of Contrractct/o►rl/Lic rise Holder
�essee/Contractor
OF Ol
O
COUNTY OFSTATE
L� C V--t
I�Q\irL
COUNTY OFCh
The r oing instr nt was acknowledg before me
�dayof
The fo oing instrument was acknowled d before me
this]adayof MA�G%\ by
this ,20Wby
"( Air l�v,
.20�
i i 1�-
Name of person making statement.
Name of persdin making statement.
Personally Known OR Produced Identification Vll�
Personally Known / OR Produced Identification
Type of Identification r�
JF I
Type of Identification
Produced
Produced
&&J 466�
0
(Sig atureofNotaryP t(sign
lure ota Public-Sta
Late of Flbic
Commission No. Com(5�47
e,.. •y� Notary Polk State Of Flo
Commission No. 6 I �der Dub -en
MY Coms
A'9Dece
'•e M1o. =xo�res za2a22
n`
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 211119