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All 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 ✓
PERMIT TYPE: Windows / Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 1705 Swain Rd., Ft Pierce, FL 34947
Property Tax ID #: 2418-313-0001-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Tolson
DETAILED DESCRIPTION OF WORK:
Replace 16 windows size-for-size—jpviw,r �cr� Cx
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 12,290.03
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kim Tolson
Name: Roberto Sanchez
Address: 1705 Swain Rd
Company: The Home Depot
City: Ft Pierce State: fL-
Zip Code: 34947 Fax:
Phone No. 772-577-1868
Address: 2455 Paces Ferry Rd
City: atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
E -Mail: kimtolson@yahoo.com
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 thepermit 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."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Li�ense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF r,C (a.E
COUNTY OF 5�. 4e,
The forgoing instrument was acknowledged before me
The forgoing instrum nt was acknowledged before me
thislT day of iye 20R. by
thisA day of 20Jr by
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Name of person making statement.
Name of person making statement.
Personally Known --' OR Produced Identification
Personally Known 0 OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(S' ature of Notary Public- Stat orifi on Hallich
(Signature of Notary Public- State of�FloridAlron Hallich
may_ r NOTARY PUBLIC
Commission Nof6�J%» tSiiATE OF FLORIDA
�oUR OTARY PUBLIC
Commission No. Tj% o� OF FLORIDA
w ` '" Comm* GG951577
- Comm# GG951577
s� e,
CE �g X IreS 112 112.024
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
1161100_1-W-