HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/28/20
Permit Number:
ro J 1 ,
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LLT ' ) "I A fBuilding Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Window
PR0POgDAMPROUEWNT LOCATION:
Address: 9106 Champions Way
Property Tax ID #: 3334-501 -0101 -000-1 Lakes at PGA Village Lot No. 23
Site Plan Name: Spencer Windows Block No. 3
Project Name: Spencer
DETAILED QESCRIPTION' OE WORK:
Replacing 3 Windows with Impact Rated Products
Horizontal Roller HR5510 NOA# 17-0411.08 Single Hung SH5500 NOA# 17-0630.05
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $
_ Shutters _ Windows/Doors _ Pond
_Generator _Roof Pitch
Sq, Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Name James Spencer
Address: 9106 Champions Way
City: Port St. Lucie, FL State: _
Zip Code: 34986 Fax:
Phone No.907-841-4895
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Michael ODonnell
Company: ODonnell Impact Windows and Storm Protection
Address-1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No 772-408-0200
E-Mail odonnelipermitting@gmail.com
State or County License CRC1331273
IT value of construction is Z5V0 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SU�F'LEMENTAL CONSTRUCTl,01U
U(N LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
ORTGAGE COMPANY: Not Applicabl
Name:
_
Name:
Address:
Address:
_
City: St
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER ONTRACTOR AFFIDVIT: Application is hereby e to obtain a permit to do the work and installation as indicated.
I hat no work or installation has commenced prior to the issuance of a permit.
ce'tLucie
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie Cou and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with le or an ttorne before commencin ork or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contrac or 1cense Holder
STATE OF FLORID I
COUNTY OF a,64i m ,
Sworn (or affirmed) and subscribed before me of
STATE OF FLORI
COUNTY OF
Swor (or affirmed) and subscribed before me of
h Pres ce or_Online Notarization
this day o 2020 by
L
P I Pre c or Online Notarization
this . ay o 2020 by i
Name of person making st ment.
Name of person making state rit.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Pr u ed _
RLIA
Produced
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(Signatu of No=� I - StatehaAllen
(Signature of tar - Statuftlaci�a�
Comm.4,�G1, 2
Commission No.'« S3Q
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Commission No. = ' Sepi3o r
REVIEWS
FRONT
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SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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