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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
1, LCJUEL
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Windows
PROPOSED IMPROVEMENT LOCATION:
Address: 3605 Crabapple Drive Port Saint Lucie, FL, 34952
Property Tax ID #: 3425-705-0003-000-9
Site Plan Name: Peterson
Project Name: Peterson
DETAILED DESCRIPTION OF WORK:
Replace 10windows size -for -size with impact
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
Lot No. 2
Block No. 41
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters X_ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: `
Cost of Construction: $ L65
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name David Peterson
Name: Roberto Sanchez
Address: 17 Sagewood DR
Company: The Home Depot
City: Pelham State: NI4
Zip Code: 03076 Fax:
Phone No. 781-296-4633
Address: 2455 Paces Ferry Rd
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
E-Mail: depson0577@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Lake
COUNTY OF Lake
Swo;n to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
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PhyAical Presence or Online Notarization
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(Signature of Notary Public- State,of-FAorida __----. _: __
(Signature of Notary Public- State of Florida_)_.,.
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Commission No. •. D. M;SSION # GG 11713
mmission No. � TIMQTHY R. O'MALLEY
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