HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 IS Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 6905 Deer Park Avenue, Fort Pierce, FL 34951
Property Tax ID#: 1301-613-0204-000-9 Lot No. 17
Site Plan Name: Block No. 146
Project Name:
DETAILED DESCRIPTION OF WORK:
Replace existing windows (14)with PGT 5500 series white vinyl insulated impact windows.
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: $ 12,935.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameStephen & Deborah Lacroix Name:Daniel W. Beard
Address:6905 Deer Park Avenue Company:Vero Glass & Mirror
City: Fort Pierce State: FL Address:1705 Old Dixie Highway
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.508-942-4829 Zip Code: 32960 Fax: 772-562-1474
E-Mail:dlacroix@aol.com Phone No772-567-3123
Fill in fee simple Title Holder on next page(if different E-Maildanb@veroglass.com
from the Owner listed above) State or County License SCC131151280
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: _ 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 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_.l;@c-Qrding your Notice of Commencement.
Igri a of Owner/Les a/Con actor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA" STATE OF FLORIDA
COUNTY OF COUNTY OF
Swor o(or affirmed)and subscribed before me of Swor (or affirmed)and subscribed before me of
P yslcal Presence or Online Notarization Physical Presence or Online Notarization
this day�ofQ (:v*min 1 �,202O by this day of Pc—t-i -� 2021 by
Name of person making statement. Name of person making sent.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced
� ��_ , f-- * Produced
(Signature of Notary Public St�te,of;F.yq;i¢as} �r �` gnature of Notary Public- ate-raf
�° +Po- Notary Public state of Florida
r G t; P =o"��y >. 1 ^I Public state of Florida
Commission No. "1 p �` � )Sartain C mission No. lto 1 (Seal)<tain
mission GG�h o° Expires 01/30/023 296871 N� emission GG 296871
o.s of ''30/2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.