HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
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
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: � �� /r;'/�7��L2 r✓�hE'L'� �/,-,h/ /r✓,�?L�
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Property Tax ID#: Lot No.�
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
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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 _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
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Cost of Construction: $ �y .Al flv Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name: MADELYN GUZMAN
Address: .5 �C' fY %7���� LC�'.1� Company: WRIGHTS IMPACT WINDOW& DOOR
City: /�7 �/C E L' State: /G Address: 7816 S. DIXIE HWY
Zip Code: .�7`��� Fax: City: WEST PALM BEACH State:FL
Phone No. 7l'64 J` /Y �� � Zip Code: 33405 Fax:
E-Mail: Phone No 661 588 7353
Fill in fee simple Title Holder on next page( if different E-Mail laura@wrightswindow.com
from the Owner listed above) State or County License CBC1262617
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 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 16f Owner/LLe,�ssee/Contractor as Agent for Owner Sig ature of ract ' ense Holder
COUNTY OFSTATE OF O I Iy1�q� STATE OF ORI,taA l 9, U COUNTY OF ,tiI�`
The for&oing instrument was acknowledged before me ThWing instrumle was acknowledged before me
this ay of 20Z6 by tl ay of 2094))y
_DGW YIQ_ 5 W i n5i5ryl t ---
Name of pterson making sta ent. Name of person malliAg statement.
Personally Known OR Produced Identification Per ally Known�OR Produced Identification
Type of Identification pe f Identificatio
Produced fir °�e Notary Public State of F rOrocl ed pRyA Laura M Moss
,leanie P Shearer NOTARY PUBLIC
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Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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