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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��� '\ Permit Number:
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Building Permit Application JUL 19 2021
Planning and Development Services
St ku)ie County
Building and Code Regulation Division Commercial Residentla Prmilina
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:Window Replacement
PROPOSED IMPROVEMENT'LOCATION'
Address: 358 Q P rima Vista Blvd PSL, FL
Property Tax I D#:_ ��-'�3 O �, y D `� • Lot No.4
Site Plan Name: Block No. 38
Project Name:
DETAILED DESCRIPTION OF WORK:
Replacing windows L
New Electrical Meter Second Electrical Meter
F
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping —Shutters x Windows/Doors —Pond
Electric Plumbing —Sprinklers Generator Roof Pitch
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 2,300 Utilities: Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR.-
Name o e o ris ian Mercado Name:
Address:358 SE rims Vista Blvd Company:
City: Port baint Lucie _ State:FL Address:
Zip Code: Fax: City: State:
Phone No.561-670-06 Zip Code: Fax:
E-Mail:bbara onam(c-oao .com Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State o ounty License
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.
RECEIVED
St:blu ounty
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 TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: 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
with lender or an attorney before commencing work or recording our Notice of Commencement.
25��_�__
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF tjj� (J,(6 COUNTY OF
Swo5A to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
V.�,hysical Pres JA a or Online Notarization _Physical Presence or Online Notarization
this p(LI day of / 2024 by this_day of 2020 by
LI?A�n c�-cadrl
Name of person making statement. ,/ Name of person making statement.
Personally Known OR Produced Identification V Personally Known OR Produced Identification
Type of Ideritification I, Type of Identification
r ducedAaaoo& Produced
*�a,RU,I P� SAR Lori A.DeSalvo
(Signature of Notary Public-State of ROTARY PUB IC(Signature of Notary Public-State of Florida)
c STATE OF FLORIDA
Commission No. C W ?E Comm*GG 130 5473)mmission No. (Seal)
s�yce j9� Expires 10/20 2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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