HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Jr
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
PERMIT TYPE :
PROPOSED IMPROVEMENT LOCATION :
Address: 5015 BUCHANAN DR, PSL , FL 34952
Property Tax ID #: 3402-602-0013-000-5 Lot No .
Site Plan Name : Block No.
Project Name: MARK & RUBY THOMPSON (PING)
DETAILED DESCRIPTION OF WORK :
Replace 11 Windows
CONSTRUCTION INFORMATION :
Additional work to be performed underthispermit — check all that apply: /
_Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq . Ft of Construction : Sq . Ft. of First Floor:
Cost of Construction : $ �� t ��� Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE : CONTRACTOR:
NameMARK & RUBY THOMPSON (PING) Name: DAN BECKNER
Address: 5015 BUCHANAN DR Company: PARADISE EXTERIORS LLC
City: PSL State : FL Address: 1918 CORPORATE DR
Zip Code: 34952 Fax: City: BOYNTON BEACH State:FL
Phone N0. 770-572-5806 Zip Code : 33426 Fax:
E-Mail: Phone No 561-732-0300
Fill in fee simple Title Holder on next page ( if different E-MailPermits.paradiseext@gmail.com
from the Owner listed above) 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 MORTGAGE COMPANY: _ Not Applicable
Name : Name :
Address: Address:
City: State : City: State :
Zip: Phone Zip: Phone :
FEE SIMPLE TITLE HOLDER : Not Applicable BONDING COMPANY: _Not Applicable
Name : Name:
Ad d ress: 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 Coungmakes no representation that is granting a permit will authorize the permit holde to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants at 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."
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ig ature of ner/ Lessee/Contractor as Agent for Owner Signature of contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5ilz L Le. f- COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 2030by this akdayof D ¢e= � 20ZQ by
Name of pe on making statement, Name of person making statement.
Personally Known OR Produced Identification �_ Personally Known OR Produced Ide ' ation __—
Type of Identification Type of Identification
11
Produced. _______ Produced______._
(SignNhure of Notary Public- State of Flori �1 NOwgLL (Signature of Notary Public State of Florida ) oRF �
Commission No.�§Q� 6q 37 $2 g�° �Jp�M Dpte 26 97' mmission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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