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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: V21& 021 1/ 2q 1 Permit Number:
DECEIVED
o Building Permit Application APR 3 9 2021
Planning and Development Services Parmittkng Department
St. Lu i County
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S Ocean Dr. Lot 633 Jensen Beach, FL 34957
Property Tax ID#: ��� ' coo ' Lot No.633
Site Plan Name: Window Replacement and Door Lot 633 Block No.
Project Name: Window Replacement and Door Lot 633
DETAILED DESCRIPTION OF WORK:
Replacing all windows in house.First floor:alum fixed white impact window 361/2"x 25 3/,V&261/2"x 38"Alum casement white impact
Second^floor 37"x_63"Alum.casemenf�impact, 363/4"x4381/2" casement impact ;
72 x 747 Fixed Alum Impact x2,6'0"x 6'8"sliding alum fixed impact door,261/2"x 60"alum fixed impact x3,36 3/47 x 7T alum casement impact x2
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 X Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 1105 Sq. Ft. of First Floor: 369
Cost of Construction:$ 8000 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR: :
Jt,,
Name Luis Alberto Gallardo Name:
Address:10701 S Ocean Dr. Lot 633 Company:
City: Jensen Beach State: FL Address:
Zip Code: 34957 Fax: City: State:
Phone No.(904)-759-8249 Zip Code: Fax:
E-Mail:kandcsand@yahoo.com Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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: X Not Applicable
Name:Don J Nuelle,P.E. Name:
Address:11634SW.Rowena Address:
City: Port St.Lucie State: FL City: State:
Zip: 34987 Phone 561-629-6975 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 recording our Notice of Commencement.
Signaturb4f Owner/Lesse actor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFA�4,� COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of �Z{i�-- 7.i32tTby a 1 this day of .2020 by
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fs 14 LL-A 9 Z),D
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of ldentificatio Type of Identification
Produced r -._ ; c, Produced
— OIL, '11JUJA A M I,
(Signature of Not. AU B. HREY (Signature of Notary Public-State of Florida )
t *: 1NYCOMMISSI # G1WI7
Commission No. fc Commission No. (Seal)
c . EXPIRES:AIR 202.
Bwdud iiva Notary PUM','
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 20