HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST: BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number::�� d C15
RECEIVED
o SEP. 2 2 Wl
. . o : : St.. .
Lild'ng:PetniitAppI•tionuce
County
Permitting Planning and Development 5eivices
Building and: Code Regulation Division ''Commercial ReSI entia "
2300 Virginia.Avenue,:Fort Pierce FL 34982:..:
Phone: (772) 462-1553. Fax: (772) 462-1578: .
.PERMIT APPLICATION FOR:.Windows/doors
PROPOSED IMPROVEMENT LOCATIQN:'..
::Address:
13'01-611-0333-000-6
Property Tax ID #: "Cot No. .
Site Plan Name: Q .::: :...... :. Block No.: _
Project Name::Stan.. 9 .
DETAILED DESCRIPTION.OF WORK
Re lace existing windows/doors with im act _ : LO
... P 9 . � P � 'iD�L11 .: �-'1 �1f10�0 -5:1 CLOUr
New Electrical Meter Second'Electrical Meter
FC614STIRUCTIQWIN:FOk MA'AT-ION
Additional work to be performed under this permit=:check all that apply:
_Mechanical : ::: _Gas Tank Gas Pi in 'Shutters :. _ Pipin,,Windows/Doors :::Pond
Electric _ Plumbing _ Sprinklers ' .Generator Roof.:.. 'Pitch
Total Sq. Ft of Construction: Sq. Ft. -'of First'Floor:
11
Cost of Construction! $ D ,b�
Utilities.: _Sewer _Septic. Building Height:
OWNER/LESSEE:
CONTRACTOR: .
Name Charles;&.Nancy Stang :::':
Name: Alphonse Campanelli
Addresst:6704 Santa Clara.BLV.D :::
Company*:Storm Tight Windows: ..
.City: Fort Pierce Stated
Address:500 SW 12th Ave .
11__
Zip Code: 3495.1 - Fax:::: :
City: Deerfield Beach : State: FL
Phone No: �%�% `7i4*' tG _ :::
33442
Zip Code: . _Fax:
Phone No 561-420-0271
.&Mail:
i
Fill in fee simple Title Holder on next.page (if different : _
stormti ht pprnits@outlook.com.:.
E-Mail 9 P... @
State or County License
from the Owner listed : above)
If value of construction is 2500 or mo�e,.a RECORDED Notice of.Commencement is required:'
• .. .
q .
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is re uired: ..
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ;
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Address:
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 gr an attorney before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contra o s Agent for Owner
STATE OF FLORIDgrj rb�a�
COUNTY OF �j
swSw rn to (or affirmed) and subscribed before me of
Ph sical Pret. Vine o Online Notarization
t t day of 202p by
�'hQ�L)es
-SA-0-4q-
Name of person making statement.
Personally Known OR Produced Identification __X__
Type of Identification
', F? Notary Public - State of Florida
_ Co missipp k HH 041316
� Commission No. oFMy Co
ell ires Doc 20, 2024
Bonded through National Notary Assn.
Signature of Contractor/License Holder
STATE OF FLORID
COUNTY OFI I�
SArn to (or affirmed) and subscribed before me of
Ph ical Pr nce or Online Notarization
this day of 202(l by
Name of person making statement.
Personally Known_ OR Produced Identification
Type of Identification
(Stnat ar of Notail Public d lerri
p .Zopniri�: LATANYABOYKIN
Notary Pi blic - late of Florida
Commission No. cem�BraIN�HH 041316
•.,oen• My Comm. Expires Dec 20, 2024
Bonded through National Notary Assn.
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