HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //
Date: �� aa Permit Number: 0 6 m o 110
11-mama Building Permit Application AUG 2 2020
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Planning and Development Services 9
Building and Code Regulation Dlvision
2300 Virginia Avenue,Fort Pierce FL 34982 , S I. Lucie C unty, Permitting
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door
CYPO5ED I"Oi/EMEN IFe ATIONI
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Address: 10044 S Ocean DR Apt 401 Jensen Beach, FL 34957 .
Legal Description: SEA WINDS CONDOMINIUM APT 401 (OR 3875-1923;4001-2785)
Property Tax ID#: 4502-804-0025-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
4DTAILEDICRIPI it,FUUQIIC. .. �
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REPLACEMENT OF 3 WINDOWS (IMPACT)
ONSTRU ION INFORMAT10
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Additional work o e nerformed uncl,er t is permit—check all apply:
OHVAC Gas Tank ❑Gas Piping In Shutters t v r Windows/Doors
QElectric. L _-_I Plumbing Generator Roof Roof pitch
Total Sq. Ft of Construction: 5 Ft.of First Floor:
Cost of Construction:$,9990 9T5tp Utilities:[]Sewer Septic Building Height:
tW3ER/LESS' EkCON TRACT
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Name Gervacio J Gonzalez Name: Alphonse Campanelli
Address:10044 S Ocean DR Apt 401 Company: STORM TIGHT WINDOWS
City: Port St Lucie State: FL Address: 500 SW 12 Avenue
Zip Code: 34953 Fax: City: Deerfield Beach State:FL
Phone No.(305)898-7610 Zip Code: 33442 Fax:
E-Mail: Phone No. 561-420-0411
Fill in fee simple Title Hoi r on next page(if different E-Mail: stormtightpermits@outlook.com
from the Owner listed above) State or County License - I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE.COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contract r as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn o'jor affirmed)and subscribed before me of Sworn to.(or affirmed)and subscribed before me of
Physical Prese ce or Online Notarizationsical Presence or Online Notarization
this ay of 2020 by this ay of 2020 by
_�A 7L, /I AUYV4'�h
Name o person making statemen NaMeof erson making statement.
0,���pumrlu��'/1�/ ,,``���uunllllpl+r
Personally Known ✓/OR Produce cL '�i�i a't1A �'a Personally Known ----'--OR Prod4o
Type of Identification pAMls . , Type of Identification p4AM�.
Produced ^ '�6�NumbeS10 '® Produced G ��j®'.�
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Signat of Not P I' -State of fcffiid8� �D2:, �'; � ( ' nature of ry Public- F.iiY a '�
Co mis on No. �e p�� •�"� Commissi n �'�++�C {t ,•``�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20