HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1-0K(D�S O
Building Permit Applicati®n PA
Planning and Development Services
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Building and Code Regulation Division ST. LL'cie Co nt
2300 Virginia Avenue,Fort Pierce FL 34982 Y, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE: � t
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Address: SZjl 95 Dc(C� Dr. 4q infca'IL
Property Tax ID#:-3'�- Lot No-94- 4(o
Site Plan Name: Hayward,Wayne&Romy Block No. '�L
Project Name: Hayward,Wayne&Romy
'D-�SAILED+IDESCRIPTIONIiO�F�,W®RK f _ F . - -
Installation of impact windows.
��CONS�;TRU�_dlONf I,N,FORIVIA�TION�
Additional work to be performed under this permit-check all that apply: /
_Mechanical ^Gas Tank _Gas Piping _Shutters V Windows/Doors
_Electric _Plumbing _Sprinklers —Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 10213.00 Utilities: —Sewer _Septic Building Height:
0,WNER/�L`'E$SEE CONTRA
Name Hayward,Wayne&Romy Name:Alphonse Campanelli
Address:5211 Silver Oak Dr Company:Storm Tight Windows
City: Fort Pierce State: FL Address:500 SW 12th Ave
Zip Code: 34982 Fax: City: Deefield Beach State:FL
Phone No.(772)777'9220 Zip Code: 33442 Fax:
E-Mail: Phone No 561-420-0271
Fill in fee simple Title Hol er on next page(if different E-Mail stormtightpermits@outlook.com
from the Owner listed above) State or County License CRC046091
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.
0(0211
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: I
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 thepermit 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 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 ECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY COUNTY OF`,&-,_w,&
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l2 day of a-AcL 20>i by this ?�, day of 20 Z6 by
Name o person makin tatement. Name of person makingstatement.
Personally Known OR Produced Identification 61111Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced L--fri Prod
(Signatur f Nota S AUL I B IASE (Signatur to
OSEPH PAUL. DIBIASE
Com fission No. '2 ,State of Florida y Public — .o% a4s S
•= Comm(� � # GG 113624 Com rssion <� �: tate gfC��Dfjda No[ary Public
3�E oP' My Commission Expires „ Com s i �i #� GG 113624
September 10, 2021 =.;a,"�o � My Commission Expires
..
REVIEWS FRONT ZONING SUPERVISOR NS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.2/7/19