HomeMy WebLinkAboutBuilding Permit Application 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 X
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 13300 NW Maplewood Road, Palm City, FL 34990
Legal Description: Harbour Ridge Plat 13 Buttonbush Village Unit 43
Property Tax ID#: 4426-815-0050-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Stephen Kiss
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check a11 apply:
_J 11HVAC L Gas Tank Gas Piping Shutters �Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 9,30 Utilities. _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Stephen Kiss Name: Scott Berman
Address: 13300 NW Maplewood Road Company: Florida Window&Door
City: Palm City State:FL Address: 1125 N Dixie Highway
Zip Code: 34990 Fax: City: Lake Worth State:FL
Phone No.561-315-0990 Zip Code: 33460 Fax: 561-624-8037
E-Mail:skwaterman@comcast.net Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different E-Mail: Howard@floridawindowanddoor.com
from the Owner listed above) State or County License: CGC-1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencingXWk or recording our Notice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License o er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF J C COUNTY OF 1�'CyQ,vy� P1d�-P�1
The forgoing instrument w s acknowledged before me The forgoing instrumenj was acknowledged before me
this 4E�; day of 20 20 this�day of QC AZk a' ' 20�by
ti
Stephen Kiss 1 G �y '� Scott Berman
(Name of person acknowledging) w (Na of person acknowledging)
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'q1M&
(Signature of N to Public-State of Florida) �, E = (Sign ure of Notary Public-State of Florida)
w o � aaa
Personally Known OR Produced Identi catlTSn m Personally Known OR Produced Identification
\ O U �
Type of Identification Produced "'° Type of Identification Produced
Commission No. (Np (Seal Commission No. (Se ,�S,rt�or Florida
s o� ::� mmersia
•''•n,:u '� on GG 343472
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS