HomeMy WebLinkAboutAPPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
91r. L4;4
�, Building pp 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: IMPACT WINDOW
PROPOSED IMPROVEMENT LOCATION:
Address: 9490 S OCEAN DRIVE #610
Property Tax ID #:
Site Plan Name:
Project Name:
3535-701-0041-000-3
DETAILED DESCRIPTION OF WORK:
INSTALL( ) IMPACT WINDOWS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
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:
Cost of Construction: $ 5500. O O
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height: %a&
OWNER/LESSEE:
CONTRACTOR:
Name JOHN J & NANCY Z FLEMING
Name: MADELYN GUZMAN
Address: 9490 S OCEAN DR APT 610
Company: WRIGHT'S IMPACT WINDOW & DOOR LLC
City: JENSEN BEACH FL State: _
Zip Code: 34957 Fax:
Phone No. 772 485 9378
Address:7816 S DIXIE HW(
City: WEST PALM BEACH State: FL
Zip Code: 33405 Fax:
Phone No(561) 588-7353
E-Mail: john.fleming@efi.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Permit@wrightswindow.com
State or County License CBC1262617
IT value or construction Is ZDDU or more, a RECORDED Notice oT 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
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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 le der Oran attorney before commencing work or recording our Notice of Commencement.
Sign aR r of 0 ne /Lessee/Contractor a ent for Owner
Signa ure of Contractor/ ense Holder
STAI OF ��
STATE OF FLORIDA
COUNTY
COUNTY OF PALMALM BEACH
�
Swgrh to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
✓ Physical Presence or Online Notarization
Xx Physical Presence or Online Notarization
this dafy1fof, '!!�i(� A— 204 by
this a day of SEPT 2021 2020 by
MAGELYN GUZMAN
Name of person making st ement.
Name of person making statement.
Personally Known OR Produced Id ntification
Personally Known xx OR Produced Identification
Type of Identification
Type of Identification
Produwd � �
n
Produced ^- `
j. e of Florida
gnature of Not ti N o5 ��m� tt#q
(Sipature of rfotary P lic- S - ) to
5 �ip,>�
Commission No.
939502
F �A ii
F n;' M Comm. Ex UQ�p ec 2, 2023
mmission No. Y ough NattioM1e� �lry Assn.
JARRED COOPER KINLOCH
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