HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/19/2020 Permit Number: '�',O a 1 -405
Building Permit Application pAR 201016
Planning and Development Services
Building and Code Regulation Divisionrtm
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2300 Virginia Avenue,Fort Pierce FL 34982 ft Were county
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:
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P�ROP���SED�IMPROVEMENT�LO�CATION,;}, r � , h,
Address: 600 Willows Ave
Property Tax ID#: 3419-510-0238-000-8 Lot No.7
Site Plan Name: RIVER PARK-UNIT 2- BLK 19 LOT 7 (MAP 34/22N) Block No. 19
Project Name: 600 Willows Ave
�DETA �D1 'TLON
Replace Windovyand Sliding Glass Door
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C0 ' gUCTIOt FN'FOR1VlAr1'ON r �` � r t x
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters �4 Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 1550 Sq. Ft.of First Floor: 1550
Cost of Construction: $ Utilities: —Sewer —Septic Building Height:
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t31NNER/LESSEErAt {� CONTRACTOR f fl F a
Name Brad Bergoine/Tracy Paletti Name:Owner/Builder
Address:600 Willows Ave Company:
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City: Port St. Lucie State:_ Address:
Zip Code: 34952 Fax: City: State:
Phone No.561.506.9441 /561.634.6392 Zip Code: Fax:
E-Mail:brad@mixconsultants.com/Tracyruthpal@aol.com Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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. p
6
DESIGNER/ENGINEER: X 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 i
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such g
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 O&AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Now
Sign atu ee ntractor as Agent o r Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6& l.�z.� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2.6 day of 20&6 by this day of 20_ by
Name of person making statement. I Name of person making statement.
Personally Known OR Produced Identification I Personally Known OR Produced Identification
1 Type of Identification Type of Identification
Produced yr L Produced
I E!
(Signature of Notar§-PukLi t 'RJ, (Signature of Notary Public-State of Florida
Yp�.,, pEFu NAMARIEGIVEI.S ( g Y )
r°' •a '' (ViY 0 1AISSI01�#GG 022023
Commission No. LS _ �$;oecamber9s,2020 commission No. (Seal)
•o Bonded Thru Notary Public Underwntere. i
I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
j COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE —
RECEIVED
DATE a
COMPLETED I
iev. 2/7/19