HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
D.
COU'N'TY
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number: KAWD
Building Permit Application
Commercial Residential V_
PERMIT TYPE: Hurricane Protection
PROPOSED IMPROVEMENT LOCATION
Address: 8530 Belfty PI, Port St. Lucie, FL 34986
Property Tax ID ##: 3327-701-0035-000-9 Lot No32
Site Plan Name: Block No.
Project Name: Richard Lubelski
DETAILED DESCRIPTION OF WORK:
Install Hurricane Protection Products on (1) opening i-_ 112CI 1 U P - 1t,,4&,
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – cheek all that apply:
_Mechanical ^Gas Tank `Gas Piping VShutters
Electric _Plumbing ,Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
5497 00
—Windows/Doors
_ Roof Pitch
Cost of Construction: $ i Utilities: —Sewer _._Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameRichard Lubelski
Name: Brian Rist
Address:8530 Belfty PI
Company: Storm Smart Building Systems
City: Port St. Lucie State: FL
Zip Code: 34986 Fax:
Phone No.(772) 460-9008
Address: 6182 Idlewild St
City: Fort Myers Stater
Zip Code: 33966 Fax: 884-330-8277
Phone No 561-229-0048
E -Mail: ibi2pga@comcast.net
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E-MailYSarzuela@StormSmartSE.com
State or County License CRC056857
VQIUW U1 WINDUuc.uun a ?c:)Uu or more, a KMUHUtU r4once OT LOmmencementis 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 priorto 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 covenantsthat may restrict
or prohibit such
structure. Please consult with your Home Owners Association and review your deed fo, 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 N Y PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMM NT ST CORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU END T O N ClNG, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOU ITOF O CE T °
Signatur of Owner/ Lessee/Contractor as Agent for Owner
Sig e of Contractor/license Hold
STATE OF FLORJDA
STATE OF FLORIDA
COUNTY OF V6C
COUNTY OF_L_
The forgoing instrumentas acknowledged before me
The forgoing instrument was acknowledged before me
this CL day of I--_, 2020 by
this J'k day of r�---J 2010 by
Bc h o_*- d. L �, a l lit
22r) &6
Name of person making statement.
Name of person making st ement. -------
Personally Known —OR Produced Identification �_
Identification
Personally KnowJ�i
Type of Identificatio
--�
Type of identification
Produced— _—_—_
Produced___
L
Yesenia Sarzuela
I.A. 11
Yesenia Sarzuela
{signature of Not ry Public ,� E OF FLORIDA
(Signature of N�I�TARY PUBLIC
i =
Commission No. � �— • Rg GG317472
-STATE OF FLORIDA
Commission No. y (_Vm0# GG317472
9n0•
972 xpires 3128/2023
�_—
,Nc 9n Expires 3128/2023
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