HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/15/20 Permit Number:
C� lk .
` '� `! }" BuildingPermit Application pp cation
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FORMindOWS
PRO.P05ED IMPROVEMENT LOCATION:
Address: 12903 NW Harbour Ridge Blvd
Property Tax ID #: 4426-815-0008-000-8 Harbour Ridge - Buttonbush Village Unit 1 Lot No -
Site Plan Name: Erroll Stafford Block No.
Project Name: Stafford Windows
❑ETAILED DESCRIPTION OF WORK:
Replacing 5 Windows with Impact Rated Products
Picture Windows PW-5520 NOA# 19.1126.10 - Horizontal Roller H R-5510 NOA# 20-0406.01
Single Hung SH-5500 NOA# 20-0401.03 Mullions FL#261.1 NOA# 17-0630.01
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION. -
Additional work to be performed under this permit — check all thst apply:
—Mechanical _ Gas Tank _ Gas Piping _ Stutters _ Windows/Doors ` Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _ Sq. Ft. of First Floor:
Cost of Construction: $ 7,912.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE: - - CONTRACTOR:
Name Erroll Stafford
Name: Michael O'Donnell
Address:12903 NW Harbour Ridge Blvd
Company: O'Donnell Con_racting, LLC
City: Palm City FL State:_
Address:1740 NW Federal Hwy
Zip Code: 34990 Fax:
City: Stuart State: FL
Phone No.772-344-2370
Zip Code: 34994 Fax:
E-Mail:
Phony N0772-408-0200
Fill in fee simple Title Holder on next page ( if different
E-Mail odonnellpermitting@gmail.com
State or County LicenseCRC1331273
from the Owner listed above)
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
DESIGNERENGINEER: _ Not q plicable
Name:
Address:
City: State:
Zip: Phon
FEE SIMPLE TITLF,,KO' LDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
INFORMATION:
MORTGAGE COMPANY:
Name:_
Address:
City:
ZIP: Phone:
BONDING COMPA Y"
Name:
Address:
City;
Zip; Phone
Not Ao;3ieahle
State:
Not Applicable
,13WNER/ CONTRACTOR AFFIDVIT: Application is hereb ade to ootain 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
yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is In conflitt with any applicable Home Owners Association rules, by'aws 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 Enother 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 CountW and osted on the jobsite before the first inspection. If you intend to obtain financing, consult
with IQr� er o attorne b e gncm work or recordin rAo ee ❑ . me e
Sign
STATE OF FLORIDA
COUNTY OFMartln
actor as Agent for Owner f Sign hire of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 15th day of December 2020 by
Michael O'Donnell
Name of person making statement,
Personally Known x OR Produced Identification
Type of Identification
STATE OF FLORIDA
COUNTY OFMartln
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 15th day of December 2020 by
Michael O'Donnell
Name of person making statement.
Personally Known x 03 Produced Identification
Type of Identification
Produced
�5ignatuf� of Not`arul�ta#e o
�+W Eli (Si t re of otary P e c f F it en
Commission No. • I COIlll�i. G 366562 � � �G COMMAGG366562
's, Iles; � . 30, 2023 Commission No. - .� [ s 30, 2023
Amon Nata %, ' ;,�
��„�'�,.,� Bonded ThruAaronl�at�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE
COUNTER REVIEW REVIEW REVIEW � REVIEW REVIEW REVIEW
�I
RECEIVED -
DATE
COMPLETED
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