HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 Permit Number:
ifLm Ct
Planning and Development Services
Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential RES.
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION: IMPACT WINDOWS AND DOORS
Address: 5203 Feather Creek DR Fort Pierce, FL 34951
Property Tax ID #: 1312-801-0221-000-5
Site Plan Name:
Project Name: _
DETAII
INSTALL
DESCRIPTION OF WORK:
IMPACT WINDOWS AND (1) DOORS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
_ Gas Tank
_ Plumbing
Gas Piping
_ Sprinklers
_ Shutters
_ Generator
ndows/Doors
Roof
Lot No.418
Block No.
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ oZ4�am • 34 Utilities: _ Sewer _ Septic Building Height:
Pond
Pitch
OWNER/LESSEE:
CONTRACTOR:
Name EDWARD AND RACHEL STEPANIAK
Name: MADELYN GUZMAN
Address: 5203 Feather Creek DR
Company: WRIGHT'S IMPACT WINDOW & DOOR LLC
City: FORT PIERCE State: _
Zip Code: 34951 Fax:
Phone No. (772) 473-6016
Address:7816 S DIXIE HWY
City: WEST PALM BEACH State: FL
Zip Code: 33405 Fax:
Phone No(561) 588-7353
E-Mail: erasers3@att.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permit@wrightswindow.com
State or County License CBC1262617
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
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.
/: r s cy; /q":A
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signatu a of Contra for/Li pie Holder
STATE OF FLORIDA
STATE OF FLORIDA (�^ /�
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COUNTY OF V'l c.�.t CLCX/►
Sw9fn to (or affirmed) and subscribed before me of
Swor (or affirme nd subscribed before me of
Ph Ical Presence or Online Notarization
Ph sical Presen a or_ Online Notarization
this ay of202p by
this day of 202f� by
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Name of person making s atement.
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Name of perso aking to nt.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of dentification
Produced
Produ
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ignature of Notary P b c- State of Florida I
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