HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO COMPLETED FOR APPLICATION TO BE ACCEPTED
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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
PERMIT TYPE: WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 7496 COMMERCIAL CIR, FORT PIERCE, FL 34951
Property Tax ID #: 1335-801-0021-000-4 Lot No. 4
Site Plan Name: Block No. B
Project Name: EM ADAMS COMPANY
DETAILED DESCRIPTION OF WORK:
REPLACE 8 WINDOWS WITH IMPACT
USE LIKE SIZES
NO STRUCTURAL CHANGES BEING MADE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters V AWindows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 19,475 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MEDFIELD REALTY AND INVENST COR
Name: BRUCE M. TYRRELL, JR
Address: 7496 COMMERCIAL CIR
Company: KAMRELL WINDOWS & DOORS
City: FORT PIERCE State:
Address: 8200 SW LOST RIVER ROAD
City: STUART State: FL
Zip Code: 34951 Fax:
Phone No. 772-461-0532
Zip Code: 34997 Fax: 772-288-6208
E-Mail: CAT.ALAI@EMADAMSCO.COM
Phone No 772-288-6205
Fill in fee simple Title Holder on next page ( if different
E-Mail SUE@KAMRELL.COM
State or County License CGC061180
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
BONDING COMPANY: Not Applicable
FEE SIMPLE TITLE HOLDER: _ 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 authorlxe 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 OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
LENDER
�2.C,LC� i'i'!.• /G12/LQX.('i �iL.
�2l,LC.� i"�'!% /
Signature of Owner/ Les /Contract as Agent for Owner
Signature of Contractor/Li se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 22�d day of January ., 20_,I by
this 22nd day of January , 202 by
rrle
Name of person making svtatement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of No Di]ARD
t r'p ,. SUSAN MA
1 Notary PuWc - State of Florida
Commission No. .: mmission��l�3306i
' nFSL..:` My Cornm. Expires Sep �5, 20Z�s
ackrided throw h National Notary Assn.
(Signature of Not
t i•., SUSAN MARIE QDDARD
,. NotaryPublic-! tr a Florida
Commission No. 5t�
mmission ad�IR
,. oFr�...: My Comm. Expires Sep 25, 1024
National NotaryAssn.
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