HomeMy WebLinkAbout2021-01-06 HARRINGTON THOMAS permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �D a ��i Permit Numoer.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: WINDOW REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:__
Address: 8650 SOUTH OCEAN DRIVE. PH-1, JENSEN BEACH, FL 34957
Property Tax ID #: 3534-501-0067-000-4 Lot No. _
Site Plan Name: REGENCY ISLAND DUNES - BUILDING 1, UNIT PH-1 Block No,
Project Name: RESIDENTIAL WINDOW REPLACEMENT
( DETAILED DESCRIPTION OF WORK: j
REPLACE EXISTING WINDOWS WITH IMPACT WINDOWS
(2) PGT SERIES 7720A PICTURE WINDOWS AND (1) PGT SERIES 7700A SINGLE HUNG WINDOW
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 Windows/Doors _ Pond
_ Electric _-_ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 39 SF Sq. Ft. of First Floor: _
Cost of Construction: $ 2,300.00 Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name THOMAS HARRINGTON Name: STEVEN ZELENSKI
Address:8650 SO. OCEAN DRIVE, #PH-1 j Company: ZELENSKI ENTERPRISES, INC/GLASS PLUS _
j City: JENSEN BEACH, FL State: _ Address:1052 SE DIXIE CUTOFF ROAD i
Zip Code: 34957 Fax: City: STUART State: FL
Phone No. 315-723-0002 i Zip Code: 34994 Fax: 772-781-4712
E-Maii:_tJ O fl00K,_CtjY%A;Phone Na_772-283-341 1
Fill in fee simple Title Holder on next page I if different 1 E-Mail GLASSPLUS@BELLSOUTH.NET
i from the Owner listed above) State or County License 26953
I
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:
Address:
City: _ State:
1 Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Narr,e:
Address:
City!
Lip: _ —_ Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not. Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to o the work and installation as indicated.
i certify that no work or instal ation 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 °espects, 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 user: 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 and posted on the jobsite before the first inspectior . you intend to obtain financing, consult
with lender or an attorney before commencing work or recur ur Notice of Commencement.
Signature of Owner/ LesseelContracV, as Agent for Owner Ig ature of C ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY t7F�Yl�.�_�i__.._ _------------
Sworn to (or affirmed) and subscribed before me of
S orn to (or affirmed) and subscribed before me of
._ Physical Presence or _ Online Notarization
�
Physical Pres nce or _ Online Notarization
this Lilt- day of -�� 202i by
this day of �n.�_ , 202k by
A p 12 � f) CAC)
V pj�
Name of person making statement. � J
Name of person making statement.
Personally Known OR Produced Identification
Personally Known A_ OR Produced Identification
—_
Type of Identification
Type of Identification
Produced
i Produced
gna re of Notary Public- State of Florida j
(Si atur of Notary Public State 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
-- i
COMPLETED _.
E
Notary Public State Of Flondfi < o 4� Notary Public State of Florida
Julie Nixon Julie Nixon
,Y .
My Commission GG 316574 y My Commission GG 316574
p Expires 07/17/2023 < O� Expires 07/1712023