HomeMy WebLinkAboutPermit Appztl-�(tlbA
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
1Ur� L.UG1Ef
P E 0 I_ ° I✓ � Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5800 RAINTREE TRL
Property Tax ID #:
Site Plan Name:
3402-610-0157-000-1
Project Name: (2nb,.L± Sr) i J('_ N
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:
Lot No.
Block No.
_Mechanical — Gas Tank — Gas Piping _ Shutters x Windows/Doors — Pond
— Electric —Plumbing — Sprinklers — Generator — Roof Pitch
Total Sq. Ft of Construction: Q
Cost of Construction: $ I q t
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Alphonse Campanelli
Address: 5800 RAINTREE TRL
Company: Storm Tight Windows
City: Fort Pierce State: _
Zip Code: 34982 Fax:
Phone No.
Address: 500 SW 12th Ave
City: Deerfield Beach State: FL
Zip Code: 33442 Fax:
Phone No 561-420-0271
E-Mail: S1%(P1- ci0-dY-+ M'H:5ai1 �r�up}r�'C�_
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail S M f mS� Cis }t0�
State or County License SCC131151799
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: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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,
G
LG�►4„ ►i�P P�
SignatuSignature
re of Own r/ Lessee/Contractor as Agent for Owner
Si nature of Contractor/Li nse Holder
STATE OF FLORIDA ,0
STATE OF FLORIDA Qom,
COUNTY OF V
COUNTY OF Bi oWOLA-d
Sworn to (or affirmed) and subscribed before me of
X Ph sical PreseUp, or Online Notarization
this day of 2020 by
Sworn to (or affirmed) and subscribed before me of `
Playsical Prese"e or Online Notarization
this ju day of b 2020 by
1�rJ�4—�/�3i��
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known YC OR Produced Identification
Type of Ide 'ficaD n
Pro uce
Type of Identification
PreAuced
hin
LA TANYA 10YKIN
($I ure of tary Public- tat ry
Commission 4 at 0413ejw
a n m. Eapkes Dec 20, 2024
No. S�'"
National Notary Assn.
Notary Pub • Sta
I a re otary P lic- State f ' ' 'da) LATANYADD��
C Ission x HCommission
Commission No. „• �SQ .Eapireswqh
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.