HomeMy WebLinkAboutBuilding permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
ti R- J =
Ufflolls
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 X Residential
PERMIT TYPE: Replacement of Window with Impact
PROPOSED IMPROVEMENT LOCATION:
Address: 10310 S Ocean DR Apt 510 Jensen Beach, FL 34957
Property Tax ID #: 4511-515-0048-000-0
Site Plan Name: Lamphere
Project Name: Lamphere
DETAILED DESCRIPTION OF WORK:
Replacement of Window with
FL NOA 20-0406.04
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 2.439
_ Generator
Sq. Ft. of First Floor:
Lot No.
Block No.
-4 Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJudy M Lamphere
Name: Jeffrey Walsh
Address:10310 S Ocean DR Apt 510
Company: Liberty Impact Windows & Doors Inc
City: Jensen beach State: FL-
Zip Code: 34957 Fax:
Phone No. 989-277-3797
Address: 257 SE Monterey Road
City: Stuart State: FL
Zip Code: 34994 Fax: 772-324-8578
Phone No772-444-7112
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail info@fibertyimpactwindows.com
State or County LicenseCGC 1528257
•• --•-- -•--••�••" •�•• •� +�+�� �� ����, �, a noa.vnvc� Moot' oT 6ommencemenc is requirea.
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:_ JGn'I[S lYugo
Name:
Address: l NC a-l'h
Address:
City: &L, tc.tl)n State: Ft
Zip: 31!� 2/ Phone SLI JLl• ? fw
City: State:
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 RE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER A ATT RNEY BEFORE RECORDING YOUR NOTICE OF COMM "
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Signature of V Iliviner/ Lessee/Contractor as Agent for Owner
Signature of C tractor/License Holder
STATE OF FLORIDA�(i
COUNTY OF
STATE OF FLORIDA
COUNTYOF rn(t(fii)
The forgoing instr enIt was acknowledged before me
this day of (>> :i-C•� 20j17 by
The f rgoIng instrum t was a knowledged before me
this A day of F� 20_joby
Name of person maki g statement.
Name of person making state ent.
Personally Known W/OR Produced identification
Type of Identification
Produced (IL -I
Personally Known OR Produced Identification
Type of Identification
Produced
(Signatu otary Public- State CHRISTINA FORT
• F-. Notary Public - State o
Commission No. `G 3 �j ` I Commission F GO 93
My Comm. Expires Dec
Bonded through National Not
Sign t of Notary Public State o a
,. CHRISTINA FORTIN
Florida r" .¢r.'
_ .a - .`� Notary Public -state of F
g6�s�p scion No. 6 G S37 `!(.�/ ,~^"s,�" aljommission GO 9374
,ib23 'Fan nMy Comm. Expires Dec 5.
ry Assn. Bonded through National Nota
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VEGETATION
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SEA TURTLE
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