HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
O
110 c co' a B ° Building Permit Application
Planning and Development services
auildingand Code Regulation Division Cofl mercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 4624578
PERMITAPPLICATION FOR: Windows
PROPOSED IMPROVEMENT LOCATION:
Address: 409 WILLOWS AVE
Property Tax ID k: 3419-510-0181-000-3
Lot No. 16
Site Plan Name:
/� Block No. 16
Project Name: fit? l (tok LA) I mo W S
DETAILED DESCRIPTION OF WORK:
Replace existing windows with impact windows
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 x Windows/Doors _Pond
_ Electric
_ Plumbing
Sprinklers
_ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Sq.
Ft. of First Floor:
Cost of Construction: $
9.106.00
Utilities:
_ Sewer _ Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:
NameAmanda Geller
Name:Alphonse Campanelll
Address:409 WILLOWS AVE
Company: Stormtight windows
City: Port Saint Lucie, FL 34952 State: _
Zip Code: Fax:
Phone No. 401-5(PL ) &00
Address: 500 12th Ave
City: Deerfield State;11
Zip Code: 33442 Fax:
Phone No 407-564-1800
E-Mail: S-f pn)o1�Q
h+
(c +eQm
C 5 -epro
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail stormtight@teamk5.com
State or County License CRC046091
If value of construction is 2500 or more, a RECORDED Notice of Commencement is requtred.
if value of HAVc is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER ENGINEER: x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State: _
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: x Not Applicable
BONDING COMPANY: x 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 permlt 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
strut€ure. Please consult vnth 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•resldential 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 attorneybefore commencing work or recordingour Notice of Commencement.
04
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature 6f Contractor/License Hold r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm Beach
COUNTY OF Palm Beach
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or _Online Notarization
this _ day of August 2020 by
x Physical Presence or. Online Notarization
this _ day of August 2020 by
Amanda G%,ellwer
Alj�?hors2 Cam�nelt
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification x
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced DL/
Produced
(5 ature of Notary Public- State of Florida)
(Sig r ry Pu lit• State of Florida )
Commission No.a0 D 16 (Seal)
Commission No. GA Qu47i I (p (Seal)
REVIEWS
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SUPERVISOR
PLANS
VEGETATION
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MANGROVE
COUNTER
REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.