HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
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Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential V
Address: 4903 S Header Canal Rd, Ft Pierce, FL 34945
Property Tax ID #: 3202-500-0002-000-8 Lot No
Site Plan Name: Block No.
Project Name: Dean & Karyn Dekker
I DETAILED DESCRIPTION OF WORK: I
13 Windows
CONSTRUCTION INFORMATION:
Ib84Z.1'L, 1(sXy2.0
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 18,288
—Generator
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Dean & Karyn Dekker
Name: Steve Lambert
Address:4903 S Header Canal Rd
Company: Newsouth Window Solutions
City. Ft Pierce State: FL
Zip Code: 34945 Fax:
Phone No.772-528-5929
Address:2526 Okeechobee Blvd.
City: West Palm Beach State:FL
Zip Code:33409 Fax:561-478-4100
Phone No 561-712-9000
E-Mail:
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailwestpalmbeacb@newsoothwindow.com
State or County License SCC131151763
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 C.ANSTRUC.TION LIEN LAW t
ATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 grantingB a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Assocation 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.
Inconsideration oft he 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 afull concurrency review: room additions,
accessory structures, swimming pooh, fences, walls, signs, screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMEMaNENF MAY RESULT IN YOUR PAYING
TWICE FOR IMPROYMENTS 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
WnM YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMEIIIT.'
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Sill of VwnerlLessee/Contractor as Agent for Owner Signature of CA
STATE OF FLO�u1p ,. STATE OF FLORIj1�►
COUNTY OF nil z"uCOUNTY OF �7a//e?win C1�k�
The fo oing instrument was acknowled d before me The forgoing instrument was acknowled ed before me
this Mday of, Z A l y , 26� by this day of � T 2� by
kielr- v.n 'D� e r 0lg6 lGrvJ� eJ i-
Name of pe n making statement. Name of pers n making statement.
Personally Known OR Produced Identifcation� Personally Known ✓ OR Produced Identification
Type of kJentiFlation Type of Identification
Produced PL., Produced
(Sigfiatiure of Notary Publi eaturLFofNotJNPubIic-st a rida,y Punk sacs or PPHILIP G. PEROTT P Jennifer DuD en
Commission No. FI S!,M Florida -Notary Pu . g �y9 Fmm�saion GG 171
_t t`- mmmleaion a GG 1885 E ('('rpilM pvzal2o22
REVIEWS
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DATE
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Rev. 217119