HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/24/2021
Permit Number:
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r ' ' — - ._ 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: WINDOW/DOOR INSTALLATION
I PROPOSED IMPROVEMENT LOCATION:
Address: 2005 NW LAUREL OAK LN. PALM CITY. FL 34990
Property Tax ID #: 4425-605-0057-000-8 Lot No.
Site Plan Name:
Project Name: H
I DETAILED DESCRIPTION OF WORK:
REPLACE 28 WINDOWS WIIH IMPACT.
USING LIKE SIZES
NO STRUCTURAL CHANGES BEING MADE
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
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 30.675
OWNER/LESSEE:
Shutters
Block No.
(Affidavit required)
VWindows/Doors — Pond
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name WILLIAM K HOLMES & BETH L HOLMES
Address: 2005 NW LAUREL OAK LN
City: PALM CITY State: FL
Zip Code: 34990 Fax:
Phone No. 772-336-2269
E-Mail:WHOLMES2005 OUTLOOK.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: BRUCE M. TYRRELL JR.
company: Kamrell Windows & Doors
Address: 8200 SW LOST RIVER ROAD
City: Stuart State: FL
Zip Code: 34997 Fax: 772-288-6208
Phone No 772-288-6205
E-Mail Sue Kamrell.com
State or County License CGC061180
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: j
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
Not Applicable
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
Citv:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:.
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:
Zip:
I I.
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 your Notice of Commencement.
Signature of Owner/
STATE OF FLORIDA
COUNTY OF MARTIN
as Agent for Owner
Sworn to (or affirmed) and subscribed before me of
this day of _ , 20_ by
BRUCE M. TYRRELL JR.
Name of person making statement.
Personally Known fir/ OR Produced Identification
Type of Identification Produced
gnature of Notary Public- State of Florida )
Commission No. (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED _
DATE
COMPLETED
Phone.
VPhysical Presence or Online Notarization
r r 5USAN AARIE D03062
Notary P0111 - Sta
Commission N HMy Comm. Expires Bonded through Natipna
SUPERVISOR PLANS VEGETATION
REVIEW REVIEW REVIEW
SEA TURTLE MANGROVE
REVIEW REVIEW
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