HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number:
Building Permit Applica ion KA g 1 2020
Planning and Development Services , . '
Building and Code Regulation Division I- ' ,, .pro i�'i1 j:
2300 Virginia Avenue,Fort Pierce FL 34982 Sa
!.. L u C I e County, F L
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Res'dentW X
PERMIT TYPEW N DOW REPLACEMENT
;PRQPOSED.IMPROVEMENT,LOGATION
AddressAWSPOM00bMIN, PORT ST LUCIE, FL 34986 1 O(OS' W11-0 QU4IL_ Va-
Property Tax ID#: 3322-621-0012-000/2 Lot No.3
Site Plan Name: POLO Block No.
Project Name: POLO
DETAILED DESCRIPTION OF WORK
WINDOW REPLACEMENT 1 OPENING IMPACT
.CONSTRUCTION INFORMATION4 ' '
t
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:$ 2325.00 Utilities: —Sewer —Septic Building Height:
01NNER/LESSEE CONTRACTOR
Name CHRISTINE POLO Name:MICHAEL GOODWIN
Address:9554 AVENEL LN Company:MLG CONTRACTING LLC
City: PORT ST LUCIE State:_ Address:1450 SE GRAPELAND AVE
Zip Code: 34986 Fax: City: PORT ST LUCIE State:FL
Phone No.772-882-4122 Zip Code: 34952 Fax:
E-Mail:CPOLO@ACXIOM.COM Phone N0772-418-0560
I
Fill in fee simple Title Holder on next page(if different E-Mail MLGLLC@PROTONMAIL.COM
from the Owner listed above) State or County LicenseCGC1527586
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.
i
SUPPLEMENTAL CONSTRUCTION.LIENIAW 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: I 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
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 arV exempt from undergoing a full concurrency review.roo additions,
accessorystructures,swimming pools,f n ,walls,signs,screen rooms and accessory uses not non-residential use
"WARNING TO 01�PNER: YO R F L TO RECORD A NOTICE OF COMM Y RESULT IN YOUR PAYING
TRICE R IMPROV YOUR PROPERTY. A NOTICE OF O CE NT MUST BE RECORDED AND
POS O HE J IT ORE THE FIRST INSPECTION. IF OU OBTAIN FINANCING, CONSULT
YOU E N ORNEY BEFORE RECORDING Y R N COMMENCEMENT."
A
Si atur f Owner/Le(see ontractor as Agent for Owiwr L.Agnature ofContacto4U&nse Holder
STATE OF FLOkUPA STATE OF FLORA
COUNTY OF ` .l?J U► Q COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of V-2&44 ,20')by this k4'V day of MZs ._ ,202-6 by
Name of person making statement. ` / Name of person making statement.
PersonallyKnown OR Produced Identification `� Personally Known OR Produced Identification'
y ce
Type of Iden ' Ica ' Type of Identifi atio
Produced__ L Produced V L
(Signature of Notary Public-Sta (Signature of Notary Public-Sta
LYSA JANE CAREW =°"EYP LYSA JANE CAREW
Commission No.GL KO(0 + qP 012A IMISSION#OG941663 Commission No. Ca&ci (b p MtSE*ISSION#GG941663
OF0.°P EXPIRES:December 19,2023 OFF�oP EXPIRES:December 19,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.