HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 9102 Champions WAY
Property Tax ID#: 3334-501-0102-000-8 Lot No.24
Site Plan Name: Block No. B
Project Name: ANDRE
LMTAILED DESCRIPTION OF WORK:
REPLACE 1 ENTRY DOOR Wl SIDELIGHTS WITH IMPACT,
USING LIKE SIZES.
NO STRUCTURAL CHANGES BEING MADE.
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator i Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 4475 Utilities: -Sewer —Septic Building Height:
OWNER/LESSEE: E CONTRACTOR:
Name Jean M Andre(LF EST)Sharon P Andre Robert K Kammel Name: BRUCE M.TYRRELL, JR
Address: 9102 Champions WAY Company:KAMRELL WINDOWS& DOORS
City: Saint Lucie West State: Address:2201 SE INDIAN ST BLDG Q-4
Zip Code: 34986 Fax: City: STUART State:FL
Phone No.772-403-3344 Zip Code: 34997 Fax: 772-288-6208
E-Mail; RKKAMMEL@AOL.COM Phone No 772-288-6205
Fill in fee simple Title Holder on next page(if different E-Mail ADMIN@KAMRELL.COM
from the Owner listed above) State or County License CGC061180
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.
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 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 Horne Owners Association and review your deed for any restrictions whlch 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."
Signature of Owner/Lessee/C tractor a gent for Owner Signature of Contractor/Licelis older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MARTIN COUNTY OF MARTIN
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 13TH day of MAY , 20 by this 13TH day of MAY , 20_ by
BRUCE M TYRRELL,JR BRUCE M TYRRELL,JR
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification_ Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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