HomeMy WebLinkAboutPermit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2/9/21 Permit Number:
1� L' :.
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
I PERMIT APPLICATION FOR: Windows
rPl1OP-0SED1MPROVEME,NT I=OCATION.
Address: 8917 Champions Way
Property Tax ID #: 3334-501-0031-000-9 Lakes at PGA Village
Site Plan Name: Mark & Pam Hatfield
Project Name: Hatfield Windows
DETAILS❑ DESCRIPTION OF WORK:
Replacing 4 Windows with Impact Rated Products
Picture Window PW5520 NOA# 20-0401.16
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No.17
Block No. A
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:
Cost of Construction: $ 5,604.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Mark Hatfield Name: Michael O'Donnell
Address:6 Petticoat Lane Company: O'Donnell Contracting LLC
City: Troy, NY State: Address: 1740 NW Federal Hwy
Zip Code: 12180 Fax: City: Stuart
Phone No. 518-466-1095 Zip Code: 34994 Fax:
E-Mail: Phone No772-408-0200
Fill in fee simple Title Holder on next page ( if different E-Mail odonnellpermitting@gmail.com
from the Owner listed above) State or County License CRC1331273
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.
State: FL
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
ut31UNtK/tN(31NUK: x Not Applicable
Name:_
Address:
City:
Zip:
Ph
State:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:
Name: Name:
Address: Address:
City: City•
x Not Applicable
State:
Not Applicable
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�d posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender onorne before commencing work or recordin ur Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signa re of Co tractor/L tense Holder
STATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 9th day of February 202Q by
Michael O'Donnell
Name of person making statement.
STATE OF FLORIDA
COUNTY OFMartin
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 9th day of February , 2021 by
Micharl O'Donnell
Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Rrpduced Produced
of N
Commission
REVIEWS
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