HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 Permit Number:
COUNTY
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
PERMIT TYPE: WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address. 29 LAKE VISTA TRL 103
Property Tax ID #: 3422-500-0395-000-5
Site Plan Name:
Project Name: GOLINSKY
DETAILED DESCRIPTION OF WORK:
REPLACE 3 WINDOWS WITH IMPACT.
USING LIKE SIZES.
NO STRUCTURAL CHANGES BEING MADE.
CONSTRUCTION INFORMATION:
Lot No.
Block No -
Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters V Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 3250
Generator Roof Pitch
Sq. Ft. of First Floor:
_ Utilities: —Sewer _Septic Building Height: _
OWNER/LESSEE: CONTRACTOR:
Name James Golinsky
Address: 29 Lake Vista Tr #103
City: Port Saint Lucie State:
Zip Code: 34984 Fax:
Phone No. 34984
E -Mail: JAMESGOLINSKY@YAHOO.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: BRUCE M. TYRRELL, JR
Company: KAMRELL WINDOWS & DOORS
Address: 2201 SE INDIAN ST BLDG Q-4
City: STUART State: FL
Zip Code: 34997 Fax: 772-288-6208
Phone No 772-288-6205
E -Mail ADMIN@KAMRELL.COM
State or County License CGC061180
IT value or construction is :�zsuu 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 gray 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."
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Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/ ' ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF In/17Z T IIs COUNTY OF
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this day of, 20 by this day of ; 2� by
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Name of person making statement. Name of person making statement.
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