HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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: 3254 Lakeshore Dr Hutchinson Island FL 34949
Property Tax ID t1:1425-676-0015-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Keith Bullen
I DETAILED DESCRIPTION OF WORK:
2 Windows and 1 Doors
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Add itionaIwork tobeperformed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 8,860
Generator
Sq. Ft. of First Floor:
(o3Sl.(o
3I?IW.Z
Windows/Doors _ Pond
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
N a me Keith Bullen
N a me: Stephen Lambert
Address:3254 Lakeshore Dr
Company:Newsouth Window Solutions
City: Hutchinson Island State: FL
Zip Code: 34949 Fax:
Phone No.561-889-8777
Address:2526 Okeechobee Blvd.
City: West Palm Beach State:FL
Zip Code:33409 Fax:561-478-4100
Phone No 561-712-9000
E-Mail:
FIII in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailpermits-wbp@newsouthwindow.com
State or County License SCC131151763
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.
U iTi1# 11V i fCiN UEAI i 4i
NOON:
DESIGNER ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State:
Zip: Phone
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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 apermit 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 reviewyour 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 usesto 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
with lender or an attorney before commencing work or recording our Noti ommencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO A
STATE OF FLO
COUNTY OF�"�, QCl/1
COUNTY OF C�`� C1/1
to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
�Swor
h sical Preence or Online Notarization
Physical Presence or_/Gnline Notarization
this day of `ZLV-N �` ` . 202q by
this L_ day of dgne 2202f by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification_
Personally Known 1---�ORProduced Identification
Type of Identification D
Type of Identification
Prod 9_
Produced
gnature of otary Public- Stat
(Signature of Notary Public-S t
PHILIP G. PEROTTI
Commission No. Y ""• State o(Yd91)do-Newry Public
1a5547
Jar Notary Public State or
Commission No. l f e�gnnifer Dubien
'hK GG n
Commission q GG
?'+ My Commission Expires
commnmo�
,a^� E,prtas 01'2a2022
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