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bate.
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Co m m e rc i al
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 119 NE Estia LN Saint Lucie West, FL 34983
Property Tax ID #: 3419-540-0049-000-9
Site Plan Name:
Project Name: Bryan
Replace 8 windows size -for -size with impact
New Electrical Meter
Second Electrical Meter
Additional,work to be performed under this permit —check all that apply:
_Mechanical
_Electric
_Gas Tank
_Plumbing
Total Sq. Ft of Construction:
Cost of Construction: Construction: 8007
Name Omar Bryan
Address: 119 NE Estia LN
City: Saint Lucie West
Zip Code: 34983
Fax:
Phone No. 754-246-8957
E-Mail: marmaddog38@gmail.com
_Gas Piping
_Sprinklers
State:
Shutters
_
_Generator
Sq. Ft. of First Floor:
Residential
X
Windows/Doors
Roof
Lot No. 11
Block No.
44
Utilities: _Sewer _Septic Building Height:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Roberto Sanchez
Company: The Home Depot
Address:
Y.
2455 Paces Ferry Rd
Atlanta
Zip Code: 33039
Phone N o 754-224-2010
Fax:
Pond
Pitch
State: GA
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 0s required.
MORTGAGE COMPANY: Not Applicable
Name.
_
Address.
City: State.
Zip: Phone.
_
BONDING COMPANY: Not Applicable
_
Name:
Address:
_
City:
Zip: Phone.
_
y made to obtain a permit to do the work and installation as indicated,
he issuance of a permit.
rmit will authorize the permit holder to build the subject structure
ion rules, bylaws or and covenants that may restrict or prohibit such
and review your deed for any restrictions which may apply,
hereby agree that I will, in all respects, perform the work
>des and St. Lucie County Amendments.
�dergoing a full concurrency review: room additions,
een rooms and accessory uses to another non-residential use
e of Commencement may result in paying twice for
mmencement must be recorded in the public records of St.
�e first inspection. If you intend to obtain financing, consult
,pork or recording our Notice of Commencement.
Signature of Contractor/License Holder
STATE OF FLOf31DA
COUNTY OF I
Sworn to (or affirmed) and subscribed before me of
Physical Presence or. Online Notarization
this day of 9/5 , 202p by
./
_
Name of person making statement.
Personally Known OR Produced Identification
_
Type of Identification
Produced
3
"
Aaron Haltich
R
rak
(Signature of Notary Public- S qqTAR PUBLIC
-� STATE OF FLC+RI®A
Commission No. �''� �"'� ®(Cem GG951577
/*OF 191w Expires 1/27/2024
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