HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number:
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L' ° L" ° u — 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 : 6742 CAMPANILLA FORT PIERCE , FL 34951
Property Tax I D #: 1306-500-0253-000-5 Lot No .
Site Plan Name : Block No.
Project Name : EDWARD GRINGAUZ
DETAILED DESCRIPTION OF WORK :
Replace 5 Windows & 1 Door
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION :
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 : Sq . Ft . of First Floor:
Cost of Construction : $ 10,803 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE : CONTRACTOR:
NameEDWARD GRINGAUZ Name : DAN BECKNER
Address: 6742 CAMPANILLA Company: PARADISE EXTERIORS LLC
City: FORT PIERCE State: FL Address: 1918 CORPORATE DR
Zip Code : 34951 Fax: City: BOYNTON BEACH State :FL
Phone N0. 772-2524527 Zip Code : 33426 Fax:
E-Mail: Phone No 561432-0300
Fill in fee simple Title Holder on next page ( if different E-Mailpermits.paradiseext@gmail.com
from the Owner listed above) State or County License SCC131150472
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required .
If valueof 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 Countymakes 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 reviewyour 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 attorneybefore commencingwork or recordin our Notice of Commencement.
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Signature of Owner/ Lessee/ConVractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ,! STATE OF FLORIDA .�
COUNTY OF `l 1 Luc t* COUNTY OF C
Soyorn to (or affirmed) and subscribed before me of Swor to (or affirmed) and subscribed before me of
�_ P ysical Presence or _ Online Notarization P ysical Presence or ... Online Notarization
this day of � 202a by this � day of Z1__— 2021 by
GUWA2D bICI J [aAllZ
Name of person makinngg statement. Name of person making stat ent.
Personally Known ✓ — OR Produced Identification Personally Known OR Produced Identification
____
Type of Identification Type of Identification
Produced________ Pro du
(Signature of Notary Publ Ignature of Notary 8�3t Ge of Flt0u1lS' yM�lECgg
.TAMES D. HOWELL MyCOMM SI q
M MISSION # 00916937 Commission No.
EXPIe # �� 2057B3 Commission No. ('�') -- "gP^"'Bonded Thm poly ` '110, 2022
EXPIRES: September 26, 2023 ryPo611c Umle
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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RECEIVED
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