HomeMy WebLinkAboutPermit appA0 APPUFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. Baal Permit Number:
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Building Permit Application
Planning and Development Services
9uildingand Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR`. I
Address: 3100 N HiphwaV A1A #1205 Fort Pierce, FL 34949
Property Tax ID ii:1425-6060057-000 2 Lot No.
Site Plan Name: WindowsfDoors Block No.
Project Name: John or Ana Palacio
Install 5 Impact windows and 3 Doors _.__—
New Electrical Meter _ Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _GasTark —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; S 38,986 Utilities: —Sewer _Septic Building Height: 136
NameJohn or Ana Palacio
Address: 2255 SW Salmon Rd
City: Port St Lucie State: FL
Zip Code: 34953 Fax:
Phone No.772-626-1267
Fill in fee simpleTitle Holder on next Page (if different
from the owner IWed above)
Value
2SO0 or more, a
Name: Ronald Heath
Company: Max Guard Hurricane Windows LLC
Address:2253 Vista Pkwy Ste 12 _
City: Nest Palm Beach state:FL
Zip code:33411 Fax:
Phone No561-276-7100
E-MailRheath maxguardliurricane.com
State or County License SCC131151738
Commencement
if value of 14AVC is $7,500 of more, 2 RECORDED Naake of Commencement is requuea.
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DESIGNER/ENO [NEER: _Not
Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City:._
State: --
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
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 permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permt.
St. Lucie County makes no
which is in conflict with an
structure. Please consult im
to build the subject structure
at may restrict or prohibit such
ions 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 Buikding Codes and St, Lucie County Amendments.
The following building permit applications are exempr from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residenttai use
WARNING TO OWNER: Yourfailure to Record a Notice of Commencement mayresuh in paying twicefor
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 your Notice of Commencement,
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Signature caner t ssee/Contractpr as Agent fur Owner
-l.?t-�
Signature of tractor! Mense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF s+. L.-)L+f
COUNTY OF- %4r- Wt; f,
Sworn to (or affirmed and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or__Online Notarization
Physical Presence or_ Online Notarization
this � day of ►vsercln . 2020 by
this AL day of MAetis , 2020 by
JA^ P0.1460
000444 1iAAN^
Name of person making statement,
Name of person making statement.
-/�-OR
Personally Known OR Produced Identification
Personally Known Produced identification
Type of Identification
Type of identification
Produce L—
Produced
(Signature of Notary Public �Ijfigr Pkitow.StateofFlosyi
ignature ct Notary Pub]'*'wv
Iorida ES I
=� s Commission OHM $380
Notary Pub! $tata of fiorie
colp_m_iq#ion a HH 63041
O
mmissioh Expir
Commission No. o-' mbarilon I.
mmission No.
ission Expires
November 10, 2024
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Rev. S/6/20