HomeMy WebLinkAboutBuilding Permit Application 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 Commercial xX Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone : ( 772 ) 462-1553 fax : ( 772) 462- 1578
PERMIT APPLICATION FOR - New Impact Slid 'ing Glass Doors
PROPOSED IMPROVEMENT LOCATION : .
Address : 10152 S. Ocean Drive Unit 511
Property Tax ID #: 4502-803-0038-000-3 Lot N o.
Site Plan Name : Saunders Residence Block No ..
Project Name : Saunders Residence
DETAILED DESCRIPTION OF WORK :
Remove and dispose of existing sliding glass doors and replace with new impact sliding glass doors in
same size opening .
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 KL Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq . Ft of Construction : 135 . 82 Sq . Ft. of First Floor:
Cost of Construction : $ 15 , 800 .00 Utilities : _ Sewer _ Septic Building Height :
OWNER/LESSEE : CONTRACTOR :
NameKenneth and Cathleen Saunders Name : William Jablonski
Address : 11515 NW 51 st Place Company : Window Doctor Glass and Glazing Contractors
City : Coral Springs State : � Address : 1133 Old Dixie Highway Suite 7
Zip Code : 33076 Fax : City : Lake Park State : FL
Phone No . 754-245-2066 Zip Code : 33403 Fax : 561 -842-3677
E -Mail : S0001 95492@yahoo .com Phone No772-781 -6402
Fill in fee simple Title Holder on next page if different E- Mailwindowdoctorl @bellsouth . net
from the Owner listed above) State or County License30661
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 LIEN LAW INFORMATIO- N .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name : Name :
s Address : Address :
City . State : City: State :
Zip : Phone Zip : Phone :
f FEE SIMPLE TITLE HOLDER : Not Applicable BONDING COMPANY: Not Applicable
Name : Name :
Address : Address:
City . City:
Zi p : Phone : Zip : Phone :
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countymakes 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,
accessary 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 proper t Notice of Commencement mush be recorded in the public records of St.
Lucie Countyandpos v�"fh site before the first ins ection . Ifyouintend to obtain financing, consult
p ,
with lender o torn ore commencin work or recording Kati -,qf Comrpie;ncement .
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Signatu� w essee/Contractor as Agent for Owner ignat u re of Cont actor xicense Holder
STATE OF FLORIDA STATE OF LQ
COUNTY OF L C, COUNTY OF
Sworq,to-for affirmed and subscribed before me of Swom--to (or affirmed and subscribed before me of
r.•'physical Presence r Online Notarization Physical Presence or online Notarization
this � � - -- day o 202t by this /O day of �-'�. ,t -a , 2020 by
Name of person making statement. Name of person making statement .
Personally Known OR Produced identification Personally Known ��~- � R Produced Identification
Type of Identification Type of identification
Produced Produced
ON"
(Signature of Notary Public- St e idc-N�tary Public State of Flar� a {Si nature of Notary Public- 3at e F on a
Jennifer M Ashby �''� "� � nn�Pudic Scare of F onda
omm�asion HH 00� 50 AshbyCommission No. �'�� � (S �ires 10/21/2U22 �O rl'�ISSIOfl NO. +� �' �AI��Nlsson H 001505
or �. Aires 10121/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVI EW REVIEW REVIEW REVI EW
DATE
RECEIVED
DATE
COMPLETED
Rev . 5/ 6/ 20