HomeMy WebLinkAboutSIGNED BUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/10/2021 Permit Number:
- -
Le •
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: 9268 SHORT CHIP CIRCLE, PORT ST LUCIE, FL 34986
Property Tax ID #: 3334-501-0225-000-6 Lot No.
Site Plan Names Block No.
Project Name: PICKUP
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF ONE DOOR AND TWO SIDELITES 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 Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4,787 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name DANA JOHN PICKUP SR & JOAN DELIA PICKUP Name: BRUCE M. TYRRELL JR.
Address: 1.7 BLOSSOM ST Cornpany: KAMRELL WINDOWS.& DOORS
City: FAIRHAVEN State: 1 Address: 8200 SW LOST RIVER ROAD
Zip Code: 02719 Fax: City: STUART State: FL
Phone No. 508-509-7922 Zip Code: 34997 Fax: 772-288-6208
E-Mail: LRIDEF23�55@AOL.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:
Name:_
Address:
City:
Zip:
Phone
Not Applicable
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 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."
/7
Signature of Owner/ Less Contr or as Agent for Owner Signature of Contractor Licens Ider
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this 101h day of March 'zoo by
BRUCE M TYRRELL JR
Name of person making statement.
Personally Known �R Produced Identification
Type of Identification
Produced
(Signature of Notary
j. ... SUSAN MAAIE GODDARt
Commission No. $ • �+`'`. Noury au�� ate of Florida
Commission Y HH 033062
my Cnmm. Expires Sep 25. 2024
REVIEWS FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this 101h day of March , 20_11 by
BRUCE M TYRRELL JR
Name of person making statement.
Personally Known ✓OR Produced Identification
Type of Identification
Produced
2 LbL- _� "'v�k__
( ignature of Nota
tiY Ao SUSAN MARIE GODDARO
Commission No. No Publigqc�yyof Florida
Cammissioh � 1iH'033D42
OF ram° My comm. Expires Sep 25, 2024
5UPERVISEA TURTROVE
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