HomeMy WebLinkAboutpermit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Permit Number:
Building Permit Application
Commercial Residential
Address: 5646 SUNBERRY CIR, FORT PIERCE, FL 34951
Property Tax ID f;: 1312-502-0213-000-8
Site Plan Name:
Project Name: LEE & SHARON BROCKWAY
DETAILED DESCRIPTION OF WORK:
12 Windows & 1 Door
CONSTRUCTION INFORMATION:
Additional workto be performed under this permit—check all that apply:
_Mechanical
Electric
Gas Tank
_Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 25,770
Gas Piping
Sprinklers
_Shutters
_ Generator
Sq. Ft. of First Floor: _
Lot No.
Block No.
/Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameLEE & SHARON BROCKWAY
Name: DAN BECKNER
Address:5646 SUNBERRY CIR
Company: PARADISE EXTERIORS LLC
City: FORT PIERCE State: FL
Zip Code: 34951 Fax:
Phone N0.360-606-5771
Address:1918 CORPORATE DR
City: BOYNTON BEACH State:FL
Zip Code: 33426 Fax:
Phone No 561-732-0300
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailparadiseexteriorsllc@gmaii.com
State or County License SCC131150472
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 the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenantsthat 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 afull 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."
Signature of Owner/ Lessee/Contractor as gent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
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STATE OF FLORIDA
COUNTY OF
COUNTY OF_-
The forgoing instrum t as acknowledg before me
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The forgoing instrument was acknowledged before me
this day of—�jjB 202Qby
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Name of person making statement.
Name of person a ing statement.
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Personally Known _✓/v OR Produced Identification
Personally Known _� OR Produced Identification ---
Type of Identification
ype of Identification
Produced__----- JAMES D. HOWELI,roduced---___
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EXPIRES: Apd110, 2022
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—Th N Nniary P„NIlIInd,
(Signatureo y Public -State of Florida )
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(Sign u of Notary Public- S o
Commission No. _ (Seal)
Commission No. (Seal)
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Rev.2/7/19 \