HomeMy WebLinkAboutWhite permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
L -I JI- _
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 X
PERMITTYPE: Windows & Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 1409 NW Winters Creek Road
Property Tax ID tf: 4426-825-0009-000-6
Site Plan Name: White, Charles
Project Name: White, Charles
DETAILED DESCRIPTION OF WORK:
Replacement of 13 windows with Impact
FL NOA 17-1018.08 SH FL NOA 17-0918.09 HR
FL NOA 19-0603.02 PW
CONSTRUCTION INFORMATION:
Lot No. 8
Block No.
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:
Cost of Construction: $ 15 ('Vo O
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:_
OWNER/LESSEE:
CONTRACTOR:
Name Charles & Debra White
Name: Jeffrey Walsh
Address: 2018 NW Laurel Oak Lane
Company: Liberty Impact Windows & Doors
city_ Palm City State: FL
Zip Code: 34990 Fax:
Phone No. 919-348-1426
Address:257 SE Monterey Road
City: Stuart State: FL
Zip Code: 34994 Fax: 772-324-8578
Phone No 772A44-7112
E-Mail: NIA
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailinfo@libertyimpactwindows.com
State or County LicenseCGC 1528257
ii value of construction is $z5W 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:
X Not
Na
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Zip:
MORTGAGE COMPANY: _( Not Applicable
Address:
City:
Zip: _
BONDING COMPANY: Not Applicable
Address:
City:
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. Luce County Amendments.
The following building permit applications are exempt from undergoing a full concurency 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 $lll� BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
wrraa rrlNaR a FNnF4 nh AM%ATTARNFY RItFORE RECORDING YOUR NOTIM OFROMMENCEMENT.-
Signat Contractor/License Holder
e-r[Lessee/Lbntractor as Agent for Owner
STATE OF FLORIDI�j/J
STATE OF FLORIDA
COUNTY OF // f W '1
COUNTY OF 1Y1AA
The forgoing instrumen was acknowledged before me
The forgoing instru ent was acknowledged b me
this daVfof 20
, 7.4YI-t :
this ayof 'tL by
e of person malting stat�
Name of person making statement.
/
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Personalty Known V OR Produced Identification
Personally Known OR Produced Identification
Type of Identification _
Type of Identification
Produced :'�✓'�°�"'. CHRISTINA FORTIN
Produced J✓'° CNRISTINA FORTIN
.; o ary Public : State of Florida
y�� ��r .7 Commission 9 GG 937464
.>; • . ; ry Public - State of Florida
`: `e � Commission N GG 937464
My Comm. Expires Dec 5, 2023._o.
M1.•• My Comm. Expires Dec 5, 2023
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Bonded through National NotaryAssn.
Bonded through National Notary Assn.
(Signature of Notary Pu ic- a
(Signature of Notary Public- State of FIoripla-)
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19