HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / Permit Number:
C0UNTY
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:WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 1544 NW BUTTONBUSH CIRCLE, PALM CITY, FL 34990
Property Tax ID#: 4426-815-0054-000-5 Lot No.
Site Plan Name: Block No.
Project Name: LOMBARDO
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF 19 WINDOWS WITH IMPACT AND REPLACEMENT OF 5 DOORS WITH IMPACT,
NO STRUCTUAL CHANGES BEING MADE, USE LIKE SIZES
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters X Windows/Doors
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 7, Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name John P Lombardo Cynthia C Lombardo Name: BRUCE M.TYRRELL, JR
Address: 1544 BUTTONBUSH CIRCLE Company:KAMRELL WINDOWS &DOORS
City: PORT SAINT LU IE State: FL Address:8200 SW LOST RIVER ROAD
Zip Code: 34990 Fax: City: STUART State:FL
Phone No. 305-794-5595 Zip Code: 34997 Fax: 772-288-6208
E-Mail: JOHNPCT ME.COM Phone No 772-288-6205
Fill in fee simple Title Holder on next page(if different E-Mail SUE@KAMRELL.COM
from the Owner listed above) State or County License CGC061180
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 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 Assoclatlon 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
WI OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Si nature of Owner/Lessee/C ractor As Agent for Owner Signature of Contractor/License H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF cj ,r\ COUNTY OF 4�� n
The forga.ing instru e�t�Aw�a acknowledged before me The forgoing instrument was acknowledged before me
this day of T r 2G c:by this �U'Jay of M � 2020 by
TV(le C(Tr.
Name of person making s atement. Name of person making statement.
Personally Known �� OR Produced Identification Personally Known FOR Produced Identification
Type of Identification Type of Identification
Produced Produced_
{Signature of Notary. frr�rr (Signature of Notary Public-State of Florida)
SUSAN M GODDARD =�
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Commission No. o fltar PuaFs�al fate of Florida ,,�'�,�
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COUNTER REVIEW REVIEW REVIEW RE
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RECEIVED
DATE
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