HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Lo LL LLr
I i
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT APPLICATION FOR: Wig
PROPOSED IMPROVEMENT LOCATION: F Tr � -e—
Address: (�� U
Property Tax ID #: d D b�
Site Plan Name:
Project Name: -
(15
Lot No.
Block No.
L DETAILED DESCRIPTION OF WORK: O-P,fvp. C. I(mW>a,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply-
-Mechanical _Mechanical _, Gas Tank —Gas Piping Shutters Windows/Doors — Pond
-,,,, Electric _ Plumbing —Sprinklers
Total Sq. Ft of Construction:
Cast of Construction: $ "-
Generator
Sq. R. of First Floor:
— Roof Pitch
Utilities: Sewer T Septic Building Height:
OWNS /LESSEE:
CONTRACTOR:
Name Lseum NITYTEP
Address: U
Name:
Company:
City: State: _
Addresrs: - I
'Zipcode C S Fax'
Phone No. ::7-7 C QZ��-
E-Mail:
Fill in fee simple Title Holder on next page ( if different
r ,
City: # 2t 1U{� state. L
Zip Cade: Fax:
Phone No``i�-:14S3` 4�l IV
E-Mail S CSI M 1-jt `
from the Owner listed above)
State or County License
It value of construction is 2500 or more, a RECORDED Notice of Commencement Is requrrea.
if value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPAI.E F1VTAl. CONSTRUCTI❑Nl LIEN LAW INFOR"MATION.
5 SIGNER/ENGINEER:
Nai't'ie.
Address:
City:
Zip: -� Phone State:
FEE SIMPLE TITLE HOLDER: � Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE CC#MPANY: Name. Not Applicable
Address:
City. State:
Zip: _ , Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip=- Phone:
ERJ C(}NTRALTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worst and installation as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit.
whirhis Inconflic awith any applicableEHome-owis nerst�ociationiru es bylaws or and covenants that may. restnctbor 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, l 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 usesto another non-residential use
WARNING'TO OWNER: V failure to Record a Notice of Commencement may resu
improuernenf to yo r p ope?rty. A Notice of Commencement mu a rrlor
e/iien
e in the public twice
of St.
Lucie Count a posted n the jobsite before the first inspectio . if ou d obtain financing, consult
with lender or a torn* before commencin workorrQrdinr vo rN nf-nmrnpnrcarn—f
Signature
STATE OF
COUNTY i
M
swQrn to jdr affirmed} and subscribed before me of
Tl- Ph sicaFPresence or online Notarization
this day of 2020 by
+f.r Cal%v' Cj a_1E
Name of person making statement.
Personally Known OR produced identification
Type of identification
Owner
{signature of Notaq public State of Flo' }
" *l t MoN >i
Commission No. �155lON
G ,&y 25,
REVIEWS I
FRONT
COUNTER REI
TE
btary Se''•`
ME
Signature
STATE C
Sworn to r affirmed) and subscribed before me of
t4Ph al resence or Online Notarization
hsth s d of 2020 by
Name of person making statement.
Personally Known - 4—OR Produced ide ti cation
Type of identification
Produced
( ign ure Nota
sari pR Fituida
i� Commission No. ri AR R I
o.�r 024 p ie
NS I VEGETATION SEA TURTLE I MANGROVE
EVWI REVIEW I REVIEW REVIEW
FLORIDA SERVICES SOLUTIONS INSTALLED SALES CONTRACT
Mike Spell - -
Debbie Spencer
0240 `404 Penny Lang rv._
_ 7404 Penny Lane
Ft. Pierce FL ,
34951
Ft. Pierce FL..
_ 34951
.(772) 564 6955 _. .
772) 21 f-5646
John M_Spell@Store #owes com @
_ 9p... _e outfook.com
Mt f t i ii i' E ti ( ( I i11CC!i �iSsllif-ff ) !()."[- I '� I ( ;C S.4 r I [ e'{F f•3 i� it i::i L (-
t [T! I F l i
.PLEASE
itl3r_ Teni�ti :19 R.f "e EAD THIS 1H-NO CES TLRMS ANIO t:)NUITINS," AND DDENDUMNL, OILilci-W IN -L "L iD INI'OLtGWING rA(-,ES BEFORE 51fNING. CC7MINJ 1'lt"� THIS fTfCJN
7404 Penny Lane..._ -
Ft Pierce
_- FL
_
- 34951
ovve's 4ntill ---_
_ rotor e eliver, an�tal[ Eastern Architectural
!System. Bronze Exterior and White Interior Horizontal Roller
;1Nindow. .._..-. _. _. Picture
owe's will obtain permit and ensure . passingof inspection.
'Lowe'S will provide appropriate protection o�fithe _Qw___ _-w- p perty during_.:
installation end remove all A related dee�ris _-.___ --
c c�ivTR C T5-1 _ _ ....
__..._ 3349 49
Workis to coIrsrnence Ripon reasonable availability of Contractor andlor any special order or cust
which is anticipated to be 0 V21/2020 tfill in date]. Estimated Completion date is 02121 oE�er made Gaod(s)
�
--. /2020 — [fill in date).
LEAD SAFE iNFQRMAiTUN. Fcoerat arlei apPlicable'Stale taws require it Ell You tae provided ttr,ttt 3 tead h<3 .=aril
P ar3;Phlel su h as the Renovate Right. IMPOrtant Least Hazard informstl0fl for Families. ChitCi Care Pr'ouider;s aw! Schcr,,s B%
s:cgr€inq t!lrs Contract, Yck ackrtQwfedge having received a caps' of tars inforrilation parnphiet hefclrr work t.�can rr�tr€rr t:a?
the Polerlt'al r'$k Of the lead hazard exposure fror€i rerovalrcar, drstr,rtt tie tattlf,htet is avaiiahte at the following tyelasite Y pc rfOrrrleci in Your cltvr llinp unit Or Iacility Ac
ARBITRATION AGREEMENT. This COsl(ract pravicles that Yoi, tnrl t_ at} e's ;I' resolve all civiirr€s z rr.
AfTRITRir 'fIGRJ. Yt�tr aracl Lowe's GltrE 11R THE RIGHT tT TO GQ TO COURT iO enforckt wr v ill` Di i,.,
it s:t rsir€y Ise; lakerl to SMALL CLAIMS COURT) A NEUTRAL ARBITRAT04 tail( tfeterrr€i to Lowe sf��cCE€�rF „rfrr,f rt,fl, n
'vO T 11 luc#c1e or jury, YOU and Lowe's are iartiitled To a FAIR HEARIN . f U thi> �ir;Atr ati(]n prc,cedt€res are 51P0r E
N40RF LIMITED THAN RULES APPLICABLE IN COURT Artaitr.,tOr sjonr ; deci "f'kri t.rn s€,#);r:ci la VERY iflFvv BY A COURT. FOR MORE DTAIL& are as ertft�rroat3}e as
RB1TRATION AGREE4MEN1, WAIVER O JURY TRIAL AND WAIVER Or- CLASS CTIONI F l� r:ra" ,, =r fr. f
I11'Or' s of this, Contract. #iSHT�,
PRICE CALCi1LATIONS. !f thi;, Contract rnc,9trdes Good" Grad rt lau--ct !t?sl<3llc;tiOt, raurvic,, s s,al.t t w
Suck as per Sgtjare f0t7t t#le price may tnrju(fe inure G=ls than the a)Ctuai lifW surf,rllr fits Of Your project jn,41 1.1;. n..:
,nclkjdk3� the. Total ariot"ll'rf Goo(ls regiairt?d by Lothe's to tttlfill tIle CJrttr�i,( (iriitLr(�iritl 5r€rf,ts€, :rlatorplts at�C3 E2vi?r<'It,r�
r € tlE:r the "Estimated Product") an(l thr.. lnclailatrctn SH-,rviceg upon airs tat,'rt arrtc:uni of
it stanc o ar 120 square tool roorn may ref4tfire 140 4c;r_rarN feel or r;rtrpet 10 pr�l)3�rty ri,t€tctl t}ai� E:t€rt�t ! sr,arts:;. f>ai!urn.
rr€rrct,i rGora Ctl,9r�tc[eristi{ 5, anti the Price rotrlct r€ir tulle Inst illation Seites Uersc�cl ulac�n ;tar 14i3 sgtrr€re ft�et is(
rt=r: (c;i<nl .intai,nt of Etirllatecl Prat!€rct is t,�tsrd t€pctrl he tGtal Ciaoti, r(:13ni:tlE?rld<j by the Ers;t,:itler, t7aSr:ti
rlsitrllFr`s assessrilerit rl lr?ltt't ie c;haracteristfcs Of YOUr P1`01 :cl. 11 any Usable Goods , rc's €eft i?iggr Lot^.^e'S
�Jl,i{:r�'.trC n, tilltii€t(; 'j Price adjustment. Lowe's 5Vlll nOI Adjust tft,? Contract Rrlc('_ for [lie' r::lated fnstilikilioll st=rv� c-, s- �_„
siclnrrg ores Contract YGZ: acknrtvtedge You are: aware ct Your pfofect �3r'f a I'll
re
Si7d[lEr€tS the <�trtt3un# ofESt�rrasi�;!
PrOrluc:t, aria [flat the E,.Orrtated Prtl uct may exceed Yotrr actual pro)ecl area. tt Your prajet:l €rit:[€rdlt s the ,rest +!x=.! rrr <>
ilucrrir€if rnateri;�ls, try 5irtirl[i lt3i4 CgrliraGl You Itsr#ll� r aCknati tt3tlge hrtvinrl recE-rVE€i 'ICr�ritp!etect Flrrprtr3rt #�P_tari Oi<z,rr€rr ,;€l=
"Diagram"f prrUr 10 QX0CLrtiOn eat this Contract. Upon recic€r_st. Loire's C1t7 Iarpvi[fe Yoii vailh ttCftlitid3rka! col7tes ;)f lit= CJE t�}r:l
,t•f,:Ct= tC1N- Y:lrttd; ; 1hC- [ U Ife' fQ1,)trIgp Of Ytr€.,r larojec, area and the l LieaY tI PrOvi of The will1rli�(Mit (ot.,�{l f s.
PHOTO RELEAS By iclnirlg ttric, CCsrttrrlt'€. you grant Io Lcwe`g, it-
rc ;h :Ed:grarlhs. vidtscrF. rsr atht?r r r
13 c.s�;nlattons Ol the Prernises tlef r,�-, and attar the Illsinl!ati€an St"N-vIc:,s and :€tt vc,r-
;lr'sttt-001€: da at thy! Pre:rnisr-s j el�-OC= 1 trj this C on ir�rcf (lhe Content"1. t_ower's irrr v€�ra ;y t F i+t s rill sic flts
>hyrl(Ii'1. title- anq rrrtetr?gt rrl the Coiltent for ase in all rn- r a tfr--ta.ra;tt,-
trket ]rlcf rrtdra, vvar(dv iraerps:3r,it1 Lra:•ri . ; ,r,
n'1e('li rrFr, rt aerr1111y for any pi,rrfrcaSr { _[1., clistOMer emFce. nlam ln_4, € ner
NOTICE OF RIGHT T(� CANCEL. #f this is a
d"home solicitation sale" as defined by Fla. STAT. §501.021(1) or a
oor-to-door sale" as defined by 16 C.f'.R, § 429.0(a), and it Customer does not want the Goods or Installation
Services, Customer may cancel this Contract by providing written notice to Lowe's in person or by mail, Tlii;;
notice must indicate thot Customer does not want the Goods or Installation Services and must be delivered or
postmarked before midnight Of the third business day after Customer signs this Contract. If Customer cancels this
Contract, Lowe's may not (seep ail or part Of any cash down payment. See the attached notice of cartcetlatiorl
form to this Contract for an explanation of this right. BY executing this Contract, Customer atknowledges
receipt of two (2) completed copies of the Notice of Right to Cancel form and certifies Lowe's has in€ornlect
CListorner orally or his or tier right to cancet.
CIO NOT SIGN THIS CONTRACT UNTIL COMPLETE AND YOU HAVE READ THE NOTICES, TERMS AND CONDI FIONS
AND ADDENDUM CONTAINED ON ALL PAGES OF THIS CONTRACT. BY SIGNING BELOW, YOU ARE
ACKNOWLEDGING THAT YOU HAVE READ, UNDERSTAND AND AGREE TO THE TERMS AND CONDITIONS SET
FORTH ON ALL PAGES OF THIS CONTRACT. YOU ARE ENTITILED TO A COPY OF THIS CONTRACT AT THE TIME OF
SIGNATURE.
Lowe's Home Centers, LLC Exi,� t�r'Eta e� �� October2020
Customer acknowledges receipt of a true copy of this contract which was corrtpletefy fi#Iecf in Tailor [di
Customer's execilfion hereof_