HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED }� /
Date: Permit Number: J005 - V�1 tp
•
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 X Residential
PERMITTYPE:
I.PROPOSED IMPROVEMENT LOCATION:
Address: 10 LAKE VISTA TRL 105
Property Tax ID #: 3422-500-0131-000-7
Site Plan Name: VISTA ST LUCIE BLDG 10 UNIT 105
Project Name: Holmes -Condo Windows
Lot No_.
__. .
Block No.
DETAILED DESCRIPTION OF WORK:
Install replacement windows- 5 openings
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 0Utilities: -Sewer —Septic
OWNER/LESSEE:
Name Carey J Holmes
Address: 10 LAKE VISTA TRL # 105
City; Port St Lucie _ State:
Zip Code: 34952 Fax;
Phone No. 269-568-8115
E-Mail:,-,.-
Fill
-Mail:__._Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
Roof Pitch
Building Height:
CONTRACTOR:
Name; Karl Kandel
Company: White Aluminum
Address: 2880 SW 42nd Avenue
City: Palm City State: FL
Zip Code: 34990 Fax: 772-877-2735
Phone No 772-212-1400
E -Mail astaples@whitealuminum.com
State or County License CBC 025116
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.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 0Utilities: -Sewer —Septic
OWNER/LESSEE:
Name Carey J Holmes
Address: 10 LAKE VISTA TRL # 105
City; Port St Lucie _ State:
Zip Code: 34952 Fax;
Phone No. 269-568-8115
E-Mail:,-,.-
Fill
-Mail:__._Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
Roof Pitch
Building Height:
CONTRACTOR:
Name; Karl Kandel
Company: White Aluminum
Address: 2880 SW 42nd Avenue
City: Palm City State: FL
Zip Code: 34990 Fax: 772-877-2735
Phone No 772-212-1400
E -Mail astaples@whitealuminum.com
State or County License CBC 025116
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 LAVA INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:_ _
Address:
Address: v
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 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 BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Contractor/L tense Holder
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Martin
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledge fore me
this 1 day of May , 2t7�y
this 1 day of May 20�y
lLAN (tej
Nam 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
1Signa ur of No ry Public-Stat
p tyory pubilC State ❑f Florida
COmmISSIOn NO. GG235102g� Stapte5r
MY C0rnisncor1 GG 2351a2
4i1Q4l2Q22Expires
i na re of tary Public -State
^4r Notary Public State of
R1mission No. GG235102 (te*ge1a Staples
y Commisslorl GG 23
OTI0412922
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