HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S LLLG� .,
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: WINDOW / DOOR
PROPOSED IMPROVEMENT LOCATION:
Address: 13509 NW WAX MYRTLE TRI PALM CITY FL 34990
Property Tax ID #: 4436-601-0023-000-3
Residential x
Site Plan Name: HARBOUR RIDGE
Project Name:
DETAILED DESCRIPTION OF WORK:
REPLACE 4 WINDOW AND 3 SLIDER TO PGT VINLY IMPACT RATED
New Electrical Meter Second Electrical Meter
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 35,000.00 _ Utilities: _ Sewer _ Septic
Lot No.
Block No.
_ Pond
Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William Lambert (TR)
Name: JEFFERY J PAULY
Address: 13509 Wax Myrtle TRI
Company: JEFFERY J PAULY CONSTRUCTION INC.
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No. 215-385-1126
Address: 2420 SW MAPLEWOOD DR.
City: PALM CITY State: FL
Zip Code: 34990 Fax:
Phone No 772-263-82687
E-Mail: lambew9yahoo. com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail jjpcbc.jp@gmail.com
State or County License CBC047770
1i vaiuc ui cvnsLrucuon is c3uu or more, a KtLUKUW Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: NA Name: NA
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X Not Applicable
Name: NA
Name: NA
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 paying twice for
improvements to your property. A Notice -of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an atto=v before commencing work or recording our Notice of Cojlimencement.
0 V3�
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Si t f O er a /Contractor agent for Owner
Sign a cto is s Holder
STATE OF FL A
STATE OF FLORID
COUNTY OF
COUNTY OFF
Sworn to (or affirmed) and subscribed before me of
>-C- Phy5ical Prese�5e or Online Notarization
Sworn to (or affirmed) and subscribed before me of
Physical
thisA2tAay of 2020 by
Pres a or Online Notarization
this .V4'*day of 2020 by
Na e o person m king statemen
Name offr_sZ4 n making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification )'C
Type of Ide fication
Type of Iden 'fication
Produced Gi c. ZCCr(s�..
Produced r S k sex-—
(Signature of Notar blic- State of Florida) a Edlund-Che
(Signature of Notary Public to of Florida )
��SPitY o ARY PUBLIC
Commission Nod O IL of TAT RIC
'' �,, 11 oSp�y Corlene Edlund-Chen
Commission No.�s�L Q� TARY PUBLIC
� omm# GG011539
ST-ATE OF FLORIDA
W Comm# GG011599
NCE 19Expires
7/13/2020
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