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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
�110 LLUIC I
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: 7121 Maidstone DR Port Saint Lucie, FL 34986
Property Tax ID #: 3322-505-0143-000-2 Lot No. 134
Site Plan Name: Block No.
Project Name: Scott
DETAILED DESCRIPTION OF WORK:
Replace 18 windows + 1 door size -for -size with impact
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:
Cost of Construction: $ 23797
Sq. Ft. of First Floor: _
Utilities: —Sewer Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Barbara Scott
Name: Roberto Sanchez
Address: 7121 Maidstone DR
Company: The Home Depot
City. Port Saint Lucie State:F L
Zip Code: 34986 Fax:
Phone No. 313-930-7670
Address: 2455 Paces Ferry Rd
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
E-Mail: bsscott9@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
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.
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SUPPLEMENTAL CONSTRUCTION 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:
Name:
Address:
Citv:
Zip: Phone:_
Not Applicable
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
_Not Applicable
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
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Holder
STATE OF FLORID
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STATE OF 1`1_05IDA
COUNTY OF /Tlc
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Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
physical Presence or Online Notarization
/ Physical Prese ce or Online Notarization
this �� day
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thise� day of , 2020 by
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Name of person making statement.
Name of person making statement.
�y Aaron Hallich
Personally Known CNOT AVKlatllKIC
Personally Known OR Produced Identification
Type of Identification OF FLORIDA
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Type of Identification Aaron HaNich
_STATE
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Produced NOTARY PUBLIC
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STATE OF FLORIDA J '
Comm# GG951
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- Sta e of Flo MifeS 1/27/2024
Commission No.(Seal)
Commission No. 6�53/ (Seal)
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