HomeMy WebLinkAboutBuilding Permit Application - RosabalAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/16/2021 Permit Number:
O
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772)462-1S78
PERMIT APPLICATION FOR: Replacement Of Windows & Doors
PROPOSED IMPROVEMENT LOCATION:
Address: 16 Lake Vista Trail Apt 104 Port Saint Lucie FL 34952
Property Tax ID #: 3422-500-0214-000-3
Site Plan Name: Rosabal, Jose
Project Name:
X
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Replacement of Windows & Doors
FL NOA 22250.1
FL NOA 22267
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: $ 12,925.00 Utilities: _ Sewer — Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Jose Ruben Rosabal
Name: Jeffrey Walsh
Address: 16 Lake Vista TRL Apt 104
Company: Liberty Impact Windows and Doors
City: Port Saint Lucie State: EL
Zip Code: 34952 Fax: N/A
Phone No. 407-488-7160
Address:257 SE Monterey Road East
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No772-444-7112
E-Mail: libertypermitting@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail libertypermitting@gmail.com
State or County LicenseCGC 1528257
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMAT
DESIGNER/ENGINEER: x Not Appl
Name: icable
Address.
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not
Name: _ Applicable
Address:
rite•
Zip: Phone:
OWNER/ CONTRACT
ION.
MORTGAGE COMPANY:
Name;
Address:
City: —
Zip: --_______ Phone:
BONDING COMPANY:
-X Not Applicable
State:
Name: -f-L -�� Applicable
Address:
City:
r•
Zip: _____-____ Phone:
OR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installationas indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count
yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may aply. such
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE RE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER ATT RNEY BEFORE RECORDING YOUR NOTICE OF COMME-XCMENT.
"
Signature
as Agent for Owner
STATE OF FLOM
COUNTY OF=LL l Ic I P
Theo oing instr t was acknowledged before me
this day of 1 \\ . 20 1 by
c-
Name of pers n making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
Signature of Cttractor/License Holder
STATE OF FLORIDA
COUNTY O -- I\ ( I e-- � �
The forgoing instrument Was acknowledg d before me
this � day of 20 1 by
Name of person maki statement.
Personally Known OR Produced Identification
Type of Identification
Produced
( ignature of Notary Publi
l ���
(Signature of Notary Public-
f Florida
ip'►�
Commission No.
SoWy Pubhc Stab Of FiOrlda
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My omrfiuNon HH 057731
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Commission No.
r4epNe Stsb of Florida
w �dF Expires t0/27/2024
S i Spurfin
c My COmfMt = HH 057731
Dall Expires 10/ 7
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