HomeMy WebLinkAboutPermit Application - LipsonAll 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 APPLICATION FOR:WINDOWS
PROPOSED IMPROVEMENT LOCATION:
Address: 5851 DREAM CT. #11 D FORT PIERCE FL 34982
Property Tax I D #: 3410-507-0044-000-4
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
REPLACE 10 WINDOWS IN HOME - EXISTING STORM PANELS
New Electrical Meter
Second Electrical Meter
I CONSTRUCTION INFORMATION:
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: $ 4775.00
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ROSE LIPSON
Address: 5851 DREAM CT.#11 D
Name: MATTHEW MARKS
Company: EAST COAST ALUMINUM
City: FORT PIERCE State: _
Zip Code: 34982 Fax:
Phone No.465-0937
Address:913 EDWARDS RD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-7603
Phone No 772-464-7600
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail ECAPINC@HOTMAIL.COM
State or County License24526
If value of construction is Zsoo or more, a KtLUKUtU INIUL11t: u1 %.vnUIM1I cn' •. y. •. - -•
if value of HAVC 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:
City: State:
Zip: Phone
Address:
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 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
wetn lender or an alio
DeTore commenLlrig WUrK Ur ItLUIUMV, yUUI IVUIILC UI l VIII111CIILC111Cl11.
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S7 LUciE COUNTY OF 7. Lur_iE
Sworjto (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this 23''*day of aCy 2020 by
MAT?!'Ew M Alu"
Name of person making statement.
Personally Known 4,OR Produced Identification
Type of Identification
Produced
SW2Jr to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this 23`Aday of 1' cr. , 2020 by
/N ATTN EW /'°MAAKX
Name of person making statement.
Personally Known _ `-� OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of Florida (Signature of Notary Public- State of RUTH HOLMAN
VNrr.
dUTH HOLMAN NOTARY PUBLIC
Commission No. 60 ?3C 144ARY PUBLIC GG 973L YaTATE OF FLORIC
TE OF FLORIDA Commission No.arxrr# GG973640
* GG973640 Expires 3/26/202
312-
REVIEWS FRONT ZONING res SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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