HomeMy WebLinkAboutBuilding Permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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°IS W U' -� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial x Residential
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Dayid Parent 9(P1fJC(fnf&t of VAildo" r lci
PROPOSED IMPROVEMENT LOCATION: '
Address: 10310 South Ocean Dr #501, Jensen Beach FL, 34957
Property Tax ID #: 4511-515-0039-000-4 Lot No. 37S
Site Plan Name: G✓�+ Block No. 41 E
Project Name: eA(P Ot
DETAILED DESCRIPTION OF WORK:
Replacement of Doors with Impact
FL_ Iii d 0 - D4 a 9 19
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: J
Additional work to be performed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors _ Pond
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 13,943.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David Parent
Name:Jeffrey Walsh
Address:10310 South Ocean Dr #501
Company: Liberty Impact Windows and Doors
City: Jensen Beach FL State: FL
Zip Code: 34957 Fax:
Phone No. 31d •35y -S3�
Address:257 SE Monterey Road East
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone N07772-444-7112
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail_ /n @ /ib(fF� %MpGttWr �o�awr [em
State or County LicenseCGC 1528257
---- ----••--•---•-•• -� a �-,wmucu nocee or wmmencemem is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
MUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
uo�,v,��n/uvvu�s:cn: _,vu�rsNNu�ame
Name: �it t1 L(S I�ccq 0
Address: 331 lab 914,11- 0.
City: f3,V 4 VE, Ihvn State: �_
Zip: rival Phone Slal-3�1-�J61
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _X_NotApplicable
Address:
City:_
Zip:
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 Count 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF NCEMENT"
Signature dif Contractor/License Holder
Signature o Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA �i/1���
COUNTY OF/, /
STATE OF FLORIDA
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COUNTY OF
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thisIdayof (tlN%+1
The rgoing instru nt was a knowledged before me
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Name of person m:v:O
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Type of Identification
Type of Identification
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SUPERVISOR
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MANGROVE
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RECEIVED
DATE
COMPLETED
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