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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO-BE.ACCEPTED y ©Date: O �' APe' 21 mtit`I'umba 5--L -� { APR is ?.021 RECFI '#®"-- Sd'. Lucie County, Peen -- -- --- - - - - - Building Permit Applicatio �i- Planning and Development Services ' Luck u ty, , Building and Code Regulation Division tting 2300 Virginia Avenue,Fort Pierce FL 34982 ST• Lucie Count Phone: (772)462-1553 Fax:(772)462-1578 Commercial X Residential` y' Permitting PERMIT TYPE: Replacement of Windows PROPOSED IMPROVEMENT LOCATION: - - Address: 12398 HARBOUR RIDGE BLVD 5-7 Palm City, FL 34990 Property Tax ID#: 4426-807-0039-000-9 Lot No. Site Plan Name: Ziegler, Barbara Block No. Project Name: Ziegler, Barbara DETAILED DESCRIPTION OFWORK: Replacement of Windows with Impact FLNOA CONSTRUCTION I,NFORMAT(ON.: 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:$ 2,435 Utilities: —Sewer —Septic Building Height: OWNERAESSEE: CONTRACTOR: Name Barbara Ziegler Name:Jeffrey Walsh Address: 335 S Caldwell Cir Company:Liberty Impact Windows&Doors Inc City: Downingtown State: Address.:257 SE Monterey Road Zip Code: 19335 Fax: City: Stuart State:FL Phone No. 772-336-4614 Zip Code: 34994 Fax: 772-324-8578 E-Mail:NSA Phone No 772-444-7112 .Fill in fee simple Title Holder on next page(if different E-Mail info@libertyimpactwindows.com from the Owner listed above) State or County LicenseCGC 1528257 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: X 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: XNot 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 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB P19k BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER A ATTORNEY BEFORE RECORDING YOUR NOT OF MENCEMENT." ,,-4 OA-,) <� t4ULQ____, Si e o er Lessee/ ntractor as Agent for Owner Signat Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Ma(/Lo COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before me this�day of�/{��A��'1 ,20.,(( by this�day of Qoe'1W� ,2a// by Name of person m7?®R ent. Name of person making sta ement. Personally KnownProduced Identification Personally Known_ZOR Produced Identification Ty of Identification Type of Identification P od ced, Produced ( Ignature of Nota Public- lorida CHRISTINA FORTIN S ture o otary Public- e ?°•`^•�= Notary Public-State of Florida os CHRISTINA FORTIN IV} �` mission#GG 937464 :?� �'• Notary Public-State of F or a Commission O. '. o�` y oiri Expires Dec 5,2023 ommis5lon No. t�`� Bi/Commission#GG 937 6 My Comm.Expires Dec 5,2ol V 3 Bonded through National Notary Assn . Bon e through National Notar A n. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19