HomeMy WebLinkAboutBreisch AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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 x
PERMIT APPLICATION FOR:JOSIah E Breisch Jr
PROPOSED IMPROVEMENT LOCATION:
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Property Tax ID #: 4426-805-0022-000-1
Site Plan Name: Briesch
Project Name: Breisch
DETAILED DESCRIPTION OF WORK:
Kepiacement of Windows and Door with Impact
FLNOA 20-0401.11 FLNOA 20-0401.10 FLNOA 20-0406.03 FLNOA 20-0429.09
New Electrical Meter Second Electrical Meter
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: $ 39,468.00
Lot No.37S
Block No. 40E
Windows/Doors Pond
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
OWNER/LESSEE:
NameJosiah E Breisch Jr
Address:2249 NW Seagrass DR
City: Palm City FL
State: _
Zip Code: 34990 Fax:
Phone No.412-417-0304
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Building Height:
CONTRACTOR:
Name: Jeffrey Walsh
Company: Liberty Impact Windows and Doors
Address:257 SE Monterey Road East
City: Stuart FL
State:_
Zip Code: 34994 Fax:
Phone No 772-444-7112
E-Mail
State or County License CGC 1528257
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC 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: FL
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County d.posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with I nde attorne before commencin work or recording -your N c of Commencement.
Signat 0 w lessee/Contractor as Agent for Owner
Signature of Cont Err/Licksse Holder
STATE OF FLORIDA
COUNTY OF
STATE OF FLORIDA
COUNTY OF MekKh n
Slvyorn to (or affirmed) and subscribed before me of
Physical 'r �ggnce or Online Notarization
this day of.YJ� 2020 by
worn to (or affirmed) and subscribed before me of
Physical Pr nce or Online Notarization
this -L�— day of 2020 by
1 ��t-9u1S�'1
Name of person making 4tatement.
Personally Known - OR Produced Identification
Type of Identification
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Name of person making statement.
Personally Known V/
OR Produced Identification
Type of Identification
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