HomeMy WebLinkAboutBUILDING PERMIT All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7/21/2021 Permit Numberaw uQ �y�
91T. W. ,CIE;
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: 9650 S Ocean DR Apt 1002 Jensen Beach, FL 34957
Property Tax ID#: 4502-610-0092-000-7 Lot No.
Site Plan Name: Harms, Carol Block No.
Project Name: ill,((Y) S
DETAILED DESCRIPTION OF WORK:
Replacement of Windows& Doors
FL NOA 29714.2 FL NOA 20-1118.13
FL NOA 20-0915.01
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: $ 15,287.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Carol Harms Name:Jeffrey Walsh
Address:9650 S Ocean DR Apt 1002 Company:Liberty Impact Windows and Doors
City: Jensen Beach State: rL Address:257 SE Monterey Road East
Zip Code: 34957 Fax: City: Stuart State:FL
Phone No. 772-291-7818 Zip Code: 34994 Fax:
E-Mail:N/A Phone No772-444-7112
Fill in fee simple Title Holder on next page(if different E-Mail, )Q1; e (i'0e(ty'((-hPu C� W11odo w/S C OM
from the Owner listed above) State or County LicenseCGC 1528257
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 INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: ( Not Applicable
Namne: t I t e b a ivaCile:
Address: - �l-l" Address:
City: ( 02-� State:4 L. City: State:
Zip: ,3�{3( Phone�yl-3W-Jt1 VI Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
rity: 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 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 M ATT RNEY BEFORE RECORDING YOUR OTICE OF COMM ENT."
Signature of ner/Lessee/Contractor as Agent for Owner Signature of C tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFJ, \ �,� 1 C_ COUNTY OF IT I C
The forgoing instrument was acknowledged before me The fqr oing instrument�as/acknowledgLZ before me
this 2 1 day of 20 2] by this Lu day of J�, 20 I by
Name of person maki statement. Name o�oersonmal( g statement.
Personally Known J OR Produced Identification Personally Known--y'OR Produced Identification
Type of Identification Type of Identification
Produced Produced
l
(Signature'of Notary Public-State of Florida (Signatue'oyf_Notary Public-Stat of Florida)
�� , W1c State of Flonda 1 .1�n Notxy( Ibte of Flonda
Commission No. ''`, St Ole SpuAin o t ton No. Slepharne Spurtin
x My Commissar HH 057731 My Corrmssion HH 057731
• ` d( Expros to127102/
A
REVIEWS FRONT ZONING SUPERVISOR PLANS VELETA IO gE�iiE�l1 REVIEW
COUNTED, REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.