HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: k \- l A-:Zb
Permit Number:y C i- L J L50
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0 RECEIVED
Building Permit Application
NOV' 0 6 , 2020
Planning and Development Services
Building and Code Regulation Division Commercial ReSide"'A!, De rnent
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: INSTALLING IMPACT CERTIFIED WINDOWS/DO
`�PRC)POSED iMPR4„VEMENT LOG4TiION: X +
Address: 4710 PALMETTO DR FORT PIERCE, FL 34982
Property Tax ID #: 3402-605-0038-000-5
Site Plan Name: 4710 PALMETTO DR.
Project Name: Lundgren
Furnish and install imaact certified doors and windows at the attached locations
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 31,985.55
Name Deborah Lundgren
_ Gas Piping
Sprinklers
Lot No.15
Block No. 34
_ Shutters windows/Doors Pond
_ Generator -. Roof Pitch
Sq. Ft. of First Floor:
Utilities: — Sewer _Septic Building Height:
Address-4710 PALMETTO DR
City: FORT PIERCE State: FL
Zip Code: 34982 Fax:
Phone No.954-647-8768
E-Mail: muscles1122@gmail.com
Fill in fee simple Title Holder on next page (N different
from the Owner listed above)
Name:Joseph Labadie
Company -Central Window
Address:4388 U.S. Highway 1
City: Vero Beach State, FL
Zip Code: 32967 Fax: 772-562-8309
Phone No772-562-8161
E-Mail Joe@centralwindow.com
State or County License SCC131151288
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name'
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: w 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 pplicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult wit 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. Lude 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
with Ipndpr nr an attornpv hpforp commpncine work or recordine vour Notice of Commencement.
i
Signature of Owner/ Lessee/Contrattor as Agent for Owner
Signa actor/License Holder
STATE OF FLORIDA l
I Jop ✓eL
STATE OF FLORIDA , can
COUNTY OF I
COUNTY OF n
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Swor o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
✓
Physical Presencie or Online Notarization
Physical Presence or Online Notarization
this � day of Q D 2020 by
this day of Q[�D�� . 2020 by
'Te� k'Vn daren
Jc�lf:'Qh 6�1
Name of person making statement.
Name of person making tement.
Identification
Personally Known OR Produced Identification
Personally Known OR Produced
Type of Identification
Type of Identification
Prod u d 6^ L L-
Produ ed
c2C4, QZ�
-
(Signature of Notary blic- State of F o da)
(Signature of Notaryublic- StatecW )ridadOROTHY C LEGGETT
'Onv puce, DOROTHY C LEGGETT
Commission No. l 7 . ; ($emmisslon # GG 25692
Commission No. a�5 C(�om sston # GG 256926
Expires September 19, 20#d�ef
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Kev. 5/6/25