HomeMy WebLinkAboutBuildimg Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (oi]ILI Permit Number:
9'r, LLcLL
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: Window Replacement Residential
PROPOSED IMPROVEMENT LOCATION: St Lucie County
Address: 2300 River Hammock Lane, Fort Pierce, Florida, 34981
Property Tax ID #: 3404-702-0008-000/0 Lot No. 8
Site Plan Name: River Hammock Subdivision Block No.
Project Name: Mascara
DETAILED DESCRIPTION OF WORK:
Windows being replaced with impact windows
Remove & replace - Single windows
Remove & replace - Double windows I with Mull (NOA No. 20-0813.09)
New Electrical Meter n/a Second Electrical Meternla
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: $ 7.411 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name:Rod kaYl4 O4 D
Name Paula A Mascara
Address: 2300 River Hammock LAne
Company: 1ZCri ')Zii'>!iMCAjl� i�a15r�ZVCT10 nl
City: Fort Pierce State: _
Address:' Z305- Ra U 6'R 144M CAOc'r L 4
Zip Code: 34981 Fax:
City: roar t� tc,tC� State: f 1
Phone No. 772-465-5179
Zip Code: & ll Fax: 3)7-g60-03 Z -
_W
Phone No 777-- Z16- 11 88
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail 7J4ln+o1V D '0 42, �C
State or County License CW_ l3 Z 7Zc? 3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,So0 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name: L.f1w5cN
MORTGAGE COMPANY: x Not Applicable
Name:
Address: 5-0 1 A u 10 9r.
Address:
City: MG- ZA ey State: f
Zip: 33ttoio Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
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.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wjthlender or an attorney before commencing work or recording vou-rAotice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/ rcense Holder
STATE OF FLORIDA,STATE
OF FL O I A
,�t
COUNTY OF� \ ��C \2
COUNTYOF,_
rn to (or affirmed) and subscribed before me of
SVorn to (or affirmed) and subscribed before me of
pS hysical Presence or Online Notarization
2v hysical Presence or_Online Notarization
is_dayof 2020 by
cl�
this dayoP 2020 by
(�
Name o person making statement.
Name of person making statement.
Personally Kr�owffOR Produced Identification
Personally Know OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
-- BARBRA-A
\ 'f GAMMA AGOODMAN
Signature of Notary is-Sta ryda OI
ignatureofNotar rblic-
oo E»IIMiWtl1 T0, 2022
Commission No.\�o, ��(S�n"'��'r'
�IQrid"e�'�/GG198133
"" MardW-yW2
Commission No` ,3 �M wnrrl�rs.Was
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
• Cif