HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01— :� a GD) Permit Number.
'COUNTY
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 TYPE: WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 8742 TOMPSON POINT RD, PORT ST LUCIE, FL 34986
Property Tax ID #. 3327-704-0002-000-8
Lot No.
Site Plan Name:
Block No.
Project Name: BRENGARD
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF ONE DOUBLE ENTRY DOOR 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
Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ $7,370 Utilities: —Sewer _Septic
)L Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MICHAEL C BRENGARD KAREN C BRENGARD Name: BRUCE M. TYRRELL, JR
Address: 8742•TOMPSON POINT RD, Company: KAMRELL WINDOWS-.&,DOO.RS
City: PORT ST LUCIE State: Address: 8200 SW LOST RIVER ROAD
Zip Code: 34986 Fax: City: STUART State: FL
Phone N.o. 618-971=7853 Zip Code.. 34g9:7 Fax:. 772.288-6208
E-Mail: KCBRENGARD@GMAIL.COM Phone No 772-288-6205
Fill in fee simple Title Holder on next page ( if different E-Mail SUE@KAMRELL.COM
from the Owner listed above) State or County License CGC061180
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
Name:_
Address:
City: —
Zip:
Phone
State:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:
Not Applicable
State:
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 wlth 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
ature of Owner/ LessoejCont6ktor as Agent for Owner
STATE OF FLORIDA j
COUNTY OF�CT��
The forgoing instrument was acknowledged before me
this L(y d%y of , R LXt A 20_d L by
yr P ►�1'1 T rye 1�.�•'
Name of person making statement.
Personally Known �^ OR Produced Identification
Type of Identification
Produced
ature of
:a4 • tom; Notary Public • Statt of F45r4-a
Commission No. €a• �' mmisslon$001)33062
orrti.:= My Comm. Expires Se:
Banded through National Notary A=-sn.
Signature of ContractorPcense/1151cler
STATE OF FLORIDA
COUNTY OF (Mr-k tA
The forgoing instrument was acknowledged before me
this knay of ttrl av 20 R ( by
Tv
Name of person making statement.
Personally Known _
Type of Identificatioi
Produced
(Signature of Notary
Commission No.
R Produced Identification
— 105AMRIE GODDARD
Notary Public - State of Florida
Commissl&e* 033062
My Comm. Expires Sep 25. 2024
ed through Nationai Notary Assn.
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