HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
Planning and Development Services
Building Permit Application
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:
Residential X
Address: 1328 LANCEWOOD TER PALM CITY FL 34990
Property Tax ID #: 4426-804-0018-000-7 Lot No.
Site Plan Name: HARBOUR RIDGE Block No.
Project Name: LANCEWOOD VILLAGE
DETAILED DESCRIPTION OF WORK:
Replace whole house of 26 windows, 3 sliders,and double front door to pgt vinyl inpact
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 _ Pond
_ Electric — Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 50,000.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name DAVID KELLY (TR) JILL MARIE KELLY (TR)
Name: JEFFERY J PAULY
Address:1328 LANCEWOOD TER
Company: JEFFERY J PAULY CONSTRUCTION INC.
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No. 802-451-6233
Address: 2420 SW MAPLEWOOD DR.
City: PALM CITY State: FL
Zip Code: 34990 Fax:
Phone No 772-263-82687
E-Mail: jmkncl 79gmail.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
If value of construction is 2500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 attorney before commencing work or recording our Notice of Comraencement.
Signa e f see n rac or as Age r Owner
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Signa of r r/Li se kolder
STATE OF FL RI /
STATE OF FLORI A
COUNTY OF_
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Sworn to (or affirmed) and subscribed before me of
Phys�iral Prese or Online Notarization
this y of 2020 by
Sworn to (or affirmed) and subscribed before me of
%C Ph�yy �- I Prese or _ Online Notarization
thisZVS %ay of 2020 by
Name of person makilng statement.
Name of person ma ing statement.
Personally Known OR Produced Identification %�
Personally Known OR Produced Identification K
Type of Id ification
Type of Ide 'ficatio
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(Signature of Notary P ic- State of F�qt s�
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Commission No� f-, I ESTATE OF FLORIDA
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