HomeMy WebLinkAboutBuilding Permit AppI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce F1 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578 Commercial
Residential x
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPR VEMENT LOCATION:
Address: 11 am I E
Lo
Legal Description: 1�
Property Tax ID q: %
Lot No.��
Site Plan Name:
Block No.
/y�`1
Project Name: MOO OO a I VD
Setbacks Front Back: Right Side:
Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACEMENT OF WINDOWS (IMPACT) U 2-)
CONSTRUCTION INFORMATION:
Additional work to be e orme un er this permit — check
all apply:
CJHVAC Gas Tank Gas Piping
_ Shutters ® Windows/Doors
OElectric 0 Plumbing Sprinklers
Generator Roof
Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
n n
Cost of Construction: $ � / , Utilities
Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name: Alphonse Campanelli
Addre�s :q l� Qh
Company: STORM TIGHT WINDOWS
(�
City: _I rKl`y� _IAGQ State: FL
Address: 500 SW 12TH AVENUE
Zip Code: _ Fax:
City: DEERFIELD BEACH
State: FL
Phone No.
Zip Code: 33442 Fax: 754-227-7891
E-Mail:
Phone No. 954-320-7554
Fill in fee simple Title Holder on next page ( if different
E-Mail: stormtightpermits@outlook.com
State or County License: CRC046091
from the Owner listed above)
— —
— _J
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
`13
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
City:
Zip:.
Phone
Not
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Address: 5W SW 12TH AVENUE
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: AIphonu Campmeb
Address:
City: DEERFIEUDSEACH State:
Zip: Phone
BONDING COMPANY: _Not Applicable
Address:
Zip:
Vvirlven/ 1I.ulv I KAL I VH AI-HUVI I: 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 Countv makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anantsthat 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF c,+i
The for g instrurrAnt was acknowledged before me
this ay of I , 20'XJ by
r/onaaan �'1Je�r��rIV0
Name of person making statement
Personally Known OR Produced Identification
Type of Identification DL
Produced 1 L
SigrtgWe of Nc
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
A-0.1ded
xM"'MdfhMN024
.. E.Oinn HH OI . 2 rNM , hat Pk 20. Aw. ihmyli NaINYW NoIryAwi.
C_
Signature of Contractor/License Holder
STATE OF FLORIDA/�, �., ri,
COUNTY OF !Uf Lis
The f ig ninstru w a nowledg efore me
this day of f" / 20�by
f-HAV115e, eovnX?7ellt
Name of pertgn making statement
Personally Known - OR Produced Identification
Type of Identification
FRONT ZONING SUPERVISOR I PLANS I VEGETATION I SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW I REVIEW