HomeMy WebLinkAboutBuilding Permit ApplicatonAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Oto
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Replacement Of Windows & Doors With Impact
PROPOSED IMPROVEMENT LOCATION:
Address: 9427 S Ocean DR #55 Jensen Beach, FL 34957
Property Tax ID #: 3535-333-0001-870-1 Lot No.
Site Plan Name: Ressler, Thomas Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacement of Windows & Doors with Impact
FL NOA 22250 FL NOA 20-1208.07
FL NOA 22645.1
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 XWinclows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5,000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Tom Ressler
Name:Jeffrey Walsh
Address: 9427 S Ocean DR #55
Company: Liberty Impact Windows and Doors
City: Jensen Beach State: _
Zip Code: 34957 Fax: N/A
Phone No. 727-742-6408
Address:257 SE Monterey Road East
City: Stuart State: FL
Zip Code: 34994 Fax: N/A
Phone No 772-444-7112
E-Mail: tomressier@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail info@libertyimpactwindows.com
State or County License CGC 1528257
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
DESIGNER/ENGINEER:
Nail e:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
city.
ZIP: Phone:
LIEN LAW INFORMATION:
X Not Applicable
MORTGAGE COMPANY: _( Not Applicable
LA'iddress:
e:
State: Phone: State:
Not Applicable BONDING COMPANY:
Not Applicable
Name:
Address:
Cit
r•
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installationas 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
structure. Please consult with your Home Owners Association and review our deed for an restrictions which may apply.
y y p ibit such
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 SITE RE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER ATT RNEY BEFORE RECORDING YOUR NOTICE OF COMMMpIiC6AlENT. 1 Ii / / "
Signature of ner/ Lessee/Contractor as Agent for Owner I Signature of C tractor/License Holder
STATE OF FLORIDA
COUNTY OF j� �111('
The f r oing instrRt sis acknowledged before me
this day of ! V 1 20al by
Name of per on mak' g statement.
Personally Known OR Produced Identification
Type of Identification
Produced
(Signatuurre oT Notary Public- State o Florida )
Comm ss on No.r '� e� r,►oa sraea or F
Ste acne rlin
My C...aon HH 057731
STATE OF FLORIDA
COUNTY OF I (-)
The to going instru ent was acknowledg before me
this ---t— day of 20� by
Name of person making atement.
Personally Known OR Produced Identification
Type of Identification
Produced
Lh
(Signature of Notary Public -
Commission No. �1 1
(?fit I
of Florida
e SfaLB of Fonda
StQ an .Spurlin
F My Cmrwn*Sm HH 057731
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DATE
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