HomeMy WebLinkAboutBuilding Permit App - Windle All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: f d` S,a Permit Number:
Coul urn
i= L c w L L' tz Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax. (772)462-1578 CBDG Funding
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: '1212 River pr_, 1=nrt Pierce,_EL_34981
Property Tax ID#: 2430-502-0004-000-6 Lot No. 4
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Supply and Install PGT horizontal roller doors and (5) SH5500 sing ig a hung windows around exterior of house
Impact rated
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
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: Ce 70C.U-'�' Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Matthew Windle Name: John Jacobs
Address: 3212 River Dr. Company: John Jacobs Construction Inc.
City: Fort Pierce State: FL Address: 4701 Oleander Ave
Zip Code: 34981 Fax: City: Fort Pierce State: FL
Phone No. E- Zip Code: 34982 Fax: 772-466-6491
Mail: Phone No 772-882-8334
Fill in fee simple Title Bolder on next page(if different E-Mail j Mjacobs4701 29 mai1.corn
from the owner listed above) State or County License CB0,060421 1 19245
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:
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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners 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 our Notice of Commencement.
Signatur of Owner/L e Con r as Agent for Owner
STATE F FLORID ST LUCIE
COUN OF
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this '' day of CSC nb r ,209 II by
Name of person making statement.
Personally Known_ OR Produced Identification
Type of Identification Produced
(Signature of Not Public-State of Florida) 7 Y ow Notary Public State of Florida
Casey Binkley
Commission No. b � (Seal) My commission GG gosaao
uv n�
Expires 08/2212023
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DATE
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DATE
COMPLETED
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