HomeMy WebLinkAboutpermit app!"LICABLE INFO MUST` BE COMPLETED FOR APPLICATION TO BE ACCEPTED
/Date: d �- >� Permit Number:
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:
PROPOSED IMPROVEMENT LOCATION:
^act - - ,«,
i/
. r vn or a.ucre, rL 04"b
Property Tax ID M:3322-700-0053-000.3 Lot No 48
Site Plan Name: Windows and Doors Block No.
Project Name: Dan or Teresa Holtz --
DETAILED DESCRIPTION OF WORK:
Install 1-�IV tv i _L 'b w
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical
Electric
_Gas Tank
—Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $.d4all
_ Gas Piping
_Sprinklers
_ Shutters
—Generator
lWindows/Doors
— Roof
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height
Pond
Pitch
OWN ER/LESSEE:
CONTRACTOR: V
NameDan or Teresa Holtz
Name: Ronald Heath
Address:7652 Greenbrier Cir
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No.1 (412) 445-3179
Company: Max Guard Hurricane Windows LLC
Address:2_253 Vista Pkwy, Ste 12
City: West Palm Beach State:FL
Zip Code:33411 Fax:
Phone No 561-276-7100
E-Mail: firth h. j-h-
@ AQj c d,
Fill In fee simple Title Holder on next page (if different
from the Owner fisted above)
If VQIUQ of Construction Is 2500 or mom a RFrnRn Fn n,...i.... ..f'-.Y
E-Mail.Rheath*maxguardhurricanecom
State or County license SCC131151738
__ __ _ _ _
regmrea.
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: Applicable
Name:
_Not
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 priorto the issuance of a permit.
St. Lucie County makes no representation that is granting apermit 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 granfing ofthis 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 usesto another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result In paying twicefor
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 attorneybefore commencin work or recordin our Notice of Commencement.
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natureof Owner/ LesSe /Contractor as Agent for Owner gnaS tore of contractor/L Holder
STATE OF FLORIDA (� STATE OF FLORIpA
COUNTY OF )I\ COUNTY OF (Ll� JnC,
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Sw n to (or affirmed) and subscribed before me of Swo to (or affirmed) and subscribed before me of
_ P ysical Pres nce or Online Notarization h sical Presence or Online Notarization
this day of�, 202b by
this, ay of A 4 2026 by
S�>r M Z tx�a �l d' ije
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Name of person making atemel> Name of person making st tement.
making
TypePersonally Known OR Produced Identification Personally Known Produced Identification
Identification-
Prod cof _ Type of Identification —
ProdutedQI�
Pr ced -----
{Signature of Notary Public- State
nature of Notary Public- Stat lorida
CommissionNo.0 .ILEENMcGR RY
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�)MY U)M%ii5SION R GG3 90D mission No.McGROR
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EXI•IRES:July as,a?3 MYCnMM13910N#GG35922
1 ,,s00' EXPIRES: July 25, 202
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW
REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.