HomeMy WebLinkAboutsigned building permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 03/25/2021 Permit Number:
1 -k
•71
-- - 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
PERMIT TYPE: WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 13409 NW Wax Myrtle TRL
Property Tax ID #: 4436-601-0005-000-1 Lot No. 5
Site Plan Name Block No.
Project Name: Peterson
DETAILED DESCRIPTION OF WORK:
REPLACE 1 ENTRY DOOR AND 2 SIDELITES WITH IMPACT.
USING LIKE SIZES.
NO STRUCUTAL 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: $ 4163 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Susan W Peterson (TR) Nils P Peterson (TR)
Name: BRUCE M. TYRRELL, JR T
Address: 13409,NW Wax.M.yrtle Tr
Company: KAMRELL WINDOWS & DOORS
City: Palm City State:
Address: 8200 SW LOST RIVER ROAD
Zip Code: 34990 Fax:'
City: STUART State: FL
Phone No. 772-336-9718
Zip Code: 34997 Fax: 772-288-6208
E-Mail: SUENILS@YAHOO.COM
Phone No 772-288-6205
Fill in fee simple Title Holder on next page ( if different
E-Mail SUE@KAMRELL.COM
State or County License CGC061180
from the Owner listed above)
L—
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: _ Not Applicable
Name:_
Address:
City:
Zip:
Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
Citv:
Zip": Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone: -
Not Applicable
State:
Not Applicable
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 Assoc€ation 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."
Signature of Owner/ Lessee/C 6 tract s Agent for Owner Signature of Contractor/Lisense Holcler
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this day of 1. CL`'1 1 20-3i by
BRUCE M. TYRRELL JR.
Name of person making statement.
Personally Known x
Type of Identification
Produced
OR Produced Identification
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
thi5GLi( day of tQ 20Af by
BRUCE M. TYRRELL JR.
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(5ignatureldf Notary PUbF - St e nf Flu rid.% Is --m6_0
(5ri&titL fe of Ndfary Pub i
Si15AN OARDi
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�;Av'P •. IIAARiSta eDof Florida
Commission No. ��= Nat$
Notary` € State of Flofida
Commission No. Cori d� HH 033062
•: Commission # RH O31062
Expires lap 25, �fli4
My Comm. Expires Sep 25, 2024
"Forte° My Comm.
Bon— e
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