HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY
Building Permit ALWication
Planning and Development Services gz! � --
Building and Code Regulation Division C"
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential +�
PERMITTYPE:
Address: 19 LAKE VISTA TRL 102
Property Tax ID#: 3422-500-0254-000-5 Lot No.
Site Plan Name. Lucille Mickelson Block No.
Project Name: Lucille Mickelson
Installation of impact windows/doors DL
Additional work to be performed under this permit—check all that apply:
`Mechanical ^Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric —Plumbing Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:_ a i, a) —
Cost of Construction:$ 20000.00 Utilities: —Sewer _Septic Building Height:
Name Lucille M Mickelson(TR) Name:Alphonse Campanelli
Address:19 Lake Vista TRL Apt 102 Company:Storm Tight Windows
City: Port St Lucie State:FL Address:500 SW 12th Ave
Zip Code: 34952 Fax: City: Deerfield Beach State:FL
Phone No.(772)878-6945 Zip Code: 33442 Fax: 754-227-7891
E-Mail: Phone No 561-420-0271
Fill in fee simple Title holder on next page(if different E-Mail stormtightpermits@outlook.com
from the Owner listed above) State or County License SCC131151799
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.
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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:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y UR LENDER O AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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�Luc' t St Lucie C unt
STATE OF FLORIDA� !_ STATE OF FLO Y
COUNTY OF COUNTY OF
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t is day -� 0 y thi lay 2®
Name _-&"y n M 114"1 (4)14- 9 Li1c I
of person making sta� ame erson making sta ement.
Perso Ily Known OR Produced Identification Personally Known �oduced Identification
Type of entificationKA4==�'� Type of Identification
Produc d n_ C,-7:5s;X f CG 21942 Produced fl` K y'=F ''!
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(Signature of Notary u t e of ' (Signature of Notary Publi t
lic- e of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.