HomeMy WebLinkAboutSIGNED PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Of
�4e • 7 Building Permit Application
Planning and Development Services
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: 9400 S. OCEAN DRIVE 806
Property Tax I D #: 3535-702-0061-000-2
Site Plan Name:
Project Name:
UNIT 806
DETAILED DESCRIPTION OF W®R K:
INSTALL IMPACT ) WINDOWS AND ( I ) DOORS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION11111111111111111111111
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: $
_ Gas Piping
_ Sprinklers
Name CHRISTOPHER S & SUSAN L. ELMES
_ Shutters
Generator
Lot No.
Block No.
�' Windows/Doors
Sq. Ft. of First Floor:
Utilities: -Sewer _Septic
Address: 25 Gardineer Rd
City: Putnam Valley State: NY
Zip Code: 10579 Fax:
Phone No. 201 832 2159
E-Mail: _ wleJ Rp� • e pf {
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: MADELYN GUZMAN
Roof
Building Height:
Pond
Pitch
Company:WRIGHT'S IMPACT WINDOW & DOOR LLC
Address:7816 S DIXIE HWY
City: WEST PALM BEACH State: FL
Zip Code: 33405 Fax:
Phone No(561) 588-7353
E-Mail Permit@wrightswindow.com
State or County LicenseCBC1262617
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requ
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
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 lenAelrgan attorney before commencing work or recording our Notice of Commencement.
Signature of ppwne / Lessee/Contractor as Agent for Owner
Sign ure of Co actq @nse Holder
`✓
STATE Nev��
COUNTOY OF 1 (
COUNTY OFE OF ORIDg�ri�l
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Sworn to (or affirmed) and subscribed before me of
Pres
_
this -!L day of � 4@N by
_le�fhysical n e or Online Notarization
this day( JGMI'by
Name of person making statement.
Name of person making statement.
o `
Personally Known OR Produced Identification
Personally Known � OR Produced Identification
_
Type of Ide tification
Type of Identification
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Produced ( (k,,W6
Produced
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(Signature of Notary Public- State b ) 0
( ure of otary Public- State of Florida)
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VEGETATION
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REVIEW
REVIEW
DATE
RECEIVED
DATE
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