HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. t� Permit Number: "'
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a ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 6910 SHANNON DR
Property Tax ID#: 1301-613-0112-000-7 Lot No.�
Site Plan Name: W&WCri Block No. �
Project Name: Tajuan Q Aubrey A 1O 1 W/.
DETAILED DESCRIPTION-OF WORK:.
Replace existing windows with impact windows
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: Sq. Ft. of First Floor:
Cost of Construction:$ S f�� Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Tajuan QAubrey Name: Alphonse Campanelli
Address: 6910 SHANNON DR Company: Storm Tight Windows
City: Fort Pierce State: lC Address: 500 SW 12th Ave
Zip Code: Fax: City: Deerfield Beach State: FLU
Phone No. 2— q�O 29 Zip Code: 33442 Fax:
E-Mail: I W& I Phone No 561-420-0271
Fill in fee simple Title Aolder on next page(if different E-Mail k
from the Owner listed above) State or County Lice se S C131151799 C40 I
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.
I
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:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: 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 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 and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 1UrCy 'd COUNTY OF bf-0toow`d
Swor to(or affirmed)and subscribed before me of Swop to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization ✓ Physical Presence or Online Notarization
this f_� day of Va41 u L1q 2020 by this (-S day of STMC>V !i 2020 by
��. Uan Q u6u—eh �l aha Cc La2jNe 1 I'
Name of person making statement. Name of person making statement.
Personally Known c( OR Produced Identification Personally Known / OR Produced Identification
Type of Identification Type of Identification
Pro�uced Produced
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(Signature of Notary Public-State &ET (Signature of Notary Public-State of Florid
•Kvuei!••, om��5 a°�2 Fa`Q�°s� QQ`'O�� p„ti�60.?
Commission No. ;�� ""`•:o��{���0� Commission No.
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REVIEWS FRONT NING SUPERVISOR PLANS VEGETATION _ MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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