HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Date: �' �LJ 1 Permit Number:
y- RECEIVED
C °,� rya.
�6 ` 5.., Building Permit Application SEP 15 2021
Planning and Development Services St. U401dAnbwnty
Building and Code Regulation Division Commercial Residential Perrn�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Windows/doors
PROPOSED IMFROVENIENT LOCATION
Address: 10701 S Ocean DR Lot 823
Property Tax ID #: 4511-510-0024-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Zeno
Replace existing windowsii ows with impact
New Electrical Meter Second Electrical Meter
COIVSTRUC,TI 4N INFORMATION R � �
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: Sq. Ft. of First Floor:
Cost of Construction: $� ® Utilities: —Sewer _Septic'
Building Height:
01NNER/LESSEE
s3
Name Robert & Lisa Zeno.
Name: Alphonse Campanella
Address: 10701 S Ocean DR Lot 823
City: Jensen Beach State: EL
Zip Code: 34957 Fax:
Phone No.?��r/q�
Company: Storm Tight Windows
Address: 500 SW 12th Ave
City: Deerfield Beach State: FL
Zip Code: 33442 Fax:
p
Phone No 561-420-0271
—:772,
E-Mail:
Fill in fee simple Title Ho der on next page (if different
from the Owner listed above)
E-Mail stormtightpermits@outlook.com
State or County License (iO4
It value of construction is z5oo 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.
SUPPLEM ENTAL 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.
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 gagrney before commencing work or recording our Notice of Commencement.
Signatur of Owner/ Lessee/Contractor as Agent for Owner
Si ature of Contractor/License Ho der
STATE OF FLORID 8�y ``ll �, ArJ
COUNTY OF
STATE OF FLORIDA
COUNTY OF_1
S rn to (or affirmed) and subscribed before me of
P yslcal Pres r Online Notarization
this y day of 202� by
S rn to (or affirmed) and subscribed before me of
X yslcal Pre �c or Online Notarization
this day of 2020 by
C3e J,)6 fJ_0
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Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification Y
Personally Known OR Produced Identification
Type of Identi tines
Pr uce 1� Un
Type of Identification
ProcluGed
�Sjen atur of Not ry Public`, ! :i` " ° -
ign fur of Notary ublic
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