HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8i17/20 Permit Number:
:i LI LCllr �c
r- O
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: pool" Permit
PROPOSED IMPROVEMENT LOCATION:
Address: 4247 S Indian River Drive
Residential X
Property Tax ID #: 2435-141-0001-000-3 Lot No.
Site Plan Name: Ellen Bollinger Block No.
Project Name: Bollinger Doors
2 French Doors with Impact Rated Products
French Door FD5555 NOA# 18-1108.03
New Electrical Meter Second Electrical Meter
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: $ 9,674.00
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
_ Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ellen Bollinger
Name: Michael O'Donnell
Address:4247 S Indian River Drive
Company: O'Donnell Impact Windows and Storm Protection
City: Fort Pierce, FL State: _
Zip Code: 34982 Fax:
Phone No. 772-485-4827
Address:1740 NW Federal Hwy
City: Stuart State :FL
Zip Code: 34994 Fax:
Phone No 772-408-0200
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail odonnellpermitting@gmail.com
State or County License CRC1331273
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.
SUROLEKO71%I
CONSTRUCTlON LIEN
INFORMATION:
DESIGNER/ENGINEER: _ Not Ap cable
MORTGAGE COMPANY: _ No pplicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phon
Zip: Phone:
FEE SIMPLE TITL OLDER: _ Not Applicable
BONDING COMP _Not Applicable
Name: _
Name:
Address:
Address:
City:
City:
Phone:
Zip: Phone:
WNER/ CONTRACTOR AFFIDVIT: Application is hereby ade 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 Countyy 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, posted on the jobsite before the first inspection If you intend to obtain financing, consult
with lendz or an attorney before commencing work or record' our No ice of Commencement.
f
Signature her/ Lessee ontractor as Agent for Owner
Signature of Contractor/License Holder —
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFMam-
COUNTY OFm-nm
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
x Physical Presence or Online Notarization
this tnh day of August 2020 by
this nth day of Aq.st 2020 by
Michael O'Donnell
Michael O'Oonn.O
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Pr cd
Produced
T� I I 4 %
I I
(Si nafure f otarye of F g �pn(;Ailen
Commission No. _+c s= ,.__.�mts ljP 30, 6562
C7IPItPS JBY'
(Signatui'� o Note y Pu of Fldljt��p n glen
Commission No. _'d 3rr ��m(, ;, GC30'S�
- �{�
�`
A.
REVIEWS FRONT ZONING SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20