HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/3121 Permit Number:
V:LL CUE,,
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:Windows
PROPOSED IMPROVEMENT LOCATION:
Address: 12863 S Indian River Drive
Property Tax ID#: 4504-340-0005-000-9 Lot No.
Site Plan Name: Peter Kemp Block No.
Project Name: Kemp Windows
DETAILED DESCRIPTION OF WORK:
Replacing 12 Windows with Impact Rated Products
Single Hung SH5500 NOA#20-0401.03 Horizontal Roller HR5510 NOA#20-0406.01
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 _Windows/Doors Pond
Electric _Plumbing _Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 15,565.00 Utilities: —Sewer _Septic Building Height:
❑WNERAESSEE: CONTRACTOR:
Name Peter Kemp Name:Michael O'Donnell
Address:12863 S Indian River Drive Company:O'Donnell Contracting LLC
City: Jensen Beach, FL State: Address:1740 NW Federal Hwy
Zip Code: 34957 Fax: City: Stuart State:FL
Phone No.772-284-1595 Zip Code: 34994 Fax:
E-Mail: Phone No772-408-0200
Fill in fee simple Title Holder on next page(if different E-Mail odonneilpermitting@gmail.com
from the Owner listed above) State or County License CRC1331273
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 CONSTRUCT,10 LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: ;_-'Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING COMPANY: of 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.
Luci County and posted on the jobsite before the first inspecti n. If ou intend to obtain financing, consult
wit endOr or an attorney before commencing work or record' r Notice of Commencement.
f
ig d't urekaKowner ssee/Contract •for Owner SiRKature of Contractor/License Holder
STATE OF FLO STATE OF FLO
COUNTY OF COUNTY OF }� r
Swo oo( r affirmed)and subscribed before me of 5wor ❑(or affirmed) and subscribed before me of
✓ Poy al Presence or Online Notarization Ah I Presencg or Online Notarization
thisy of 202J by khis of , 202J by
Name of person making statement. Name of person making statement.
Personally Known � OR Produced Identification Personally Known_OR Produced Identification
Type of Identification Type of Identification
Produced Prod ced
A 11 rA4 (t J _I i _4,
31 44 M11" (-4
{Signature Notar Pub1 of Flornn Allen (Signature o Notary Publi �sft,,f Flori�IVynn Allyn
Commission No. � ~ G m #GG366562 Commission No. `'~` C GG366562
s 5 .apt. 30,2023 r EC p,30,2023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.