HomeMy WebLinkAboutPermit Application - LessinAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/22/21 Permit Number:
�o J
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: Replacement Of Windows & Doors With Impact
PROPOSED IMPROVEMENT LOCATION:
Address: 9410 Carlton RD Fort Pierce, FL 34987
Property Tax ID #: 4203-221-0001-000-1 Lot No.
Site Plan Name: Lessin, John Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacement of Windows & Doors with Impact
FL NOA 22363.6 FL NOA 22645.1 FL NOA 16804.3
FL NOA 2255.1 FL NOA 16412.1 FL NOA 21648.3
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: $ 27,743.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name John A Lessin
Name:Jeffrey Walsh
Address:9410 Carlton RD
Company: Liberty Impact Windows & Doors
City: Ft Pierce State: ti L
Zip Code: 34987 Fax:
Phone No.561-801-6329
Address:257 SE Monterey Rd
City: Stuart State: FL
Zip Code: 34994 Fax: N/A
Phone N0772-444-7112
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail info@libertyimpactwindows.com
State or County License GCG1 528257
IT value or construction is Z500 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: X Not Applicable
Address.
City:
Zip:
Phone State:
FEE SIMPLE TITLE HOLDER: _Not
Name: Applicable
Address:
rit"•
Zip: Phone:
MORTGAGE COMPANY: �( Not Applicable
Name:
Address:
City:
Zip: _—_—__-__ Phone: State: _
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation I certify that no work or installation has commenced prior to the issuance of a permit.
a s indicated.
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.
I .
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�RE THE FIRST INSPECTION. IF YOU INTEND EM OBTAIN FINANCING, CONSULT
WITH YOUR LENDER AEY BEFORE RECORDING YOUR VOTICE OF COMM
ENT.,
Signature
as Agent for Owner
STATE OF FLORID
COUNTYOF
The for oing instru ent was acknowledged before me
this day of 26) by
Name of rson ma ng statement.
Personally Known OR Produced Identification
Type of Identification
Produced
of Notary Pu
Commission No.6_ 6 +" rLks Note Pu State of Fonda
-
StepSpurlin
MY Commission HH 057731
%a„ud; Expires 10/27/024
REVIEWS I FRONT I ZONING
COUNTER , REVIEW
DATE
RECEIVED
COMPLETED
Signature of C tractor/License Holder
STATE OF FLORJDqq .
COUNTY OF_ . -'S1— I
.O
Thefgrgoing instr ent was cknowledg d before me
this oo day of r 20,11 by
Name of person ma ing statement.
Personally Known � OR Produced Identification
Type of Identification
Produced
�'
(Signature of Notary P lic- State of Florida )
Commission No. '� teary Pu
Stephanie Fonda
pu in
MY Catxrnssron HH 057731
c.._:�_ ._.__._.
SUPERVISOR I PLANS I VEGETATION rSEA� Tv URT E A
REVIEW I REVIEW REVIEW II REVIEW , REVIEW