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
23001firginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Permit Number:
Building Permit Application
Commercial Residential
PROPOSED IMPROVEMENT LOCATION:
Address 9005 One Putt PI, Port St Lucie, FI 34986
Property Tax IDlt: 3334-501-0104-000-2
Site Plan Name:
Project Name: Leslie Rosenwasser
I DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Lot No. 2
Block No. C,
SOSLt.I& 1(0842. (oA 1(3U2•
I(9gSl.(
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: -
Cost of Construction: $ 30, o go
V Windows/Doors
M.
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name Leslie Rosenwasser
Name: Steve Lambert
Address:9005 One Putt PI
Company: Newsouth Window Solutions
City: Port St Lucie State: FI
Zip Code: 34986 Fax:
Phone No.561-601-1984
Address:2526 Okeechobee Blvd.
may: West Palm Beach State:FL
Zip Code: 33409 Fax: 561-478-4100
Phone No 561-712-9000
E-Mail:
FlII In fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mailwestpalmbeach@newsouthwindow.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€iNSTRUGT" LIEN Li4
RMATION:
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 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 covenantsthat 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 ezemptfrom 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 YOUR PAYING
TWICE FOR IMPROYEMENTS 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
wrna Yroto I FMFE M AN ATFMNFY BEFORE RECORDING YOUR NOMCED AtNMENCEMENT."
Signatureof Owner Lessee/Contractor as Agent fc wner
Signature of Contractor/License Holder
STATE OF FL A
COUNTY OF
STATE OF FLOP IQ h
COUNTY OF H121M
The oing instru ent was acknowledged before me
this day of _, 2 M by
The fo oing instru ent was -acknowledged before me
this day of o c . 20 j by
% .? �te 9--cca l�r_SSP✓
c 1 Q
Name of person making statement.
Personally Known OR Produced Identification v//
Name of per on making statement.
Personally Known V---�OR Produced Identification
Type of Identification Dr
Produced l0�
Type of Identification
Produced
A44Ld
(Signature of Notary Public- State of Florida)
9-6'taz L�� -
QSjpature 6f Notary Public- State of Florida I
Commission No. (Seal)
Commission No. 1 -7q 700 (Seal)
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DATE
COMPLETED
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