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411 APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
PERMIT TYPE: Windows / Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 5732 Sterling Lake Dr., Ft. Pierce, fL 34951
Property Tax ID #: 1312-502-0159-000-1 Lot No. 409
Site Plan Name: Block No.
Project Name: Gorham
DETAILED DESCRIPTION OF WORK:
Replace 11 windows + 1 door size -for -size with impact
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Zffindows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 24,060.10
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Joseph Gorham
Name: Roberto Sanchez
Address: 5732 Sterling Lake Dr
Company: The Home Depot
City: Ft. Pierce State: 'FL-
Zip Code: 34951 Fax:
Phone No. 772-971-6613
Address: 2455 Paces Ferry Rd
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No754-224-2010
E-Mail:jgorham@irsc.edu
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
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 CONSTRUCTION LIEN LAW INFORMATION:
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 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 YOUR PAYING
TWICE FOR IMPROVEMENTS 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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contract( r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S'* 1, �`�c_�
COUNTY OF r/ENE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this )q day of 20g_v by
this LPL day of „�! 20 by
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Name of person making statement. i
Name of person making statement.
Personally Known—* OR Produced Ident n
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Personally Known OR Produced Identific
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REVIEWS
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ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
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COMPLETED
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