HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Permit Number:
Building Permit Application
PERMIT TYPE: Windows & Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 3501 W Lake Dr Fort Pierce, FL 34982
Property Tax ID #: 2427-701-0025-000-0
Site Plan Name:
Project Name: Hambrick
DETAILED DESCRIPTION OF WORK:
Replace windows size -for -size with impact
1�
CONSTRUCTION INFORMATION:
Commercial Residential X
Lot No. 23
Block No. 1
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters X Windows/Doors
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ i' W I
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Dorothy Hambrick
Name: Roberto Sanchez
Address: 3501 W Lake Dr
Company: The Home Depot
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-467-0599
Address: 2455 Paces Ferry Rd.
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
E-Mail: dshelton@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
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:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 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."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Lake
COUNTY OF Lake
The forgoing instrument was acknowledged before me
this day of IA/yl 20�4 by
The forgoing instrument was acknowledged before me
this J day of ;' o, n 20 Z 1by
hijbtr%� �cti,ti�,�"glob
�rU `� �4-, C� ;>
Name of person making statement.
Name of person makingstatement.
Personally Known4,) OR Produced Identification
`st
Personally Known <` IOR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary Public State of Fl�gp'" �n NOTARY PUBL
C(Signature of Notary Public State of ) 'STATE OF FLORI
STATE OF F L
tD>�. Comm# GG23564
Commission No.
?Comm#GG23
mmission No. is I)
� Nr;f,. Expires?/5/202:
Exnires 7/512C
22
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 1
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