HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/17/2020 Permit Number:
IM, LUCE
" a 0 D9P Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Windows
PROPOSED IMPROVEMENT LOCATION:
Address: 7667 Greenbrier Circle
Property Tax ID #: 3322-700-0103-000-9
Site Plan Name: Jim Burchell
Project Name: Burchell Windows
4 Windows with Impact Rated Products
Single Hung SH -500 NOA# 20-0401.03
Mull Bar NOA# 17-0630.01
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 _Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 4,773.00
Sq. Ft. of First Floor:
Lot No. 98
Block No.
_ Windows/Doors _ Pond
_ Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE;
CONTRACTOR:
NameJames Burchell
Name: Michael O'Donnell
Address: 7667 Greenbrier Circle
Company: O'Donnell Impact Windows and Storm Protection
City: Port St. Lucie, FL State: _
Zip Code: 34986 Fax:
Phone No. 772-429-1321
Address: 1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone N0772-408-0200
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 CRC1 331273
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.
DESIGNER/ENGINEER:
Name:
_ Not A icable
MORTGAGE COMPANY:
Name:
Not Aphcable
`
Address:
STATE OF FLOIQ� J
Address:
COUNTY OF 1 'i
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE I DER:
Name:
_ Not Applicable
BONDING CO MPA
Name:
_Not Applicable
Address: Z
i;'l�dS
Address:
Name of person making statement.
City:
City:
Personally Known OR Produced Identification
Zip: Z Phone:
Type of Identification
Zip: Phone:
Produced _
ER/ 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 fmancin _, onsult
with le er or_an attorneybefore commencingwork or record i,. / ou otice-Co encem t.
Rev. 5/b/ZU
' Signature o-rOwner essee/Contractor as AgenTfor Owner
. Signat�rre of`ctor nse Ho(d�r
STATE OF FLOR
STATE OF FLOIQ� J
COUNTY OF f 9✓�
COUNTY OF 1 'i
Swor or affirmed) and subscribed before me of
Sworn t affirmed) and subscribed before me of
Pre ce orr;_ Online Notarization
ical Pres ce r Online Notarization
this 7 • d�,y of _y�i'_s'tl9>t.�2020 by
this day of: - ,,. 2020 by
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L9 X/ ..ter W d t�
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Name of person making statement.
Name of person making statement.
Personally Known ZOR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
P oduc d _
Produced _
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/ZU