HomeMy WebLinkAboutpermit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ) G - a) - �ko ) I Permit Number:
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v - Building Permit Application
Planning and Development Services
dUildmgand Code Regulation Division Commercial Residential V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address. 450 Campbell Rd, Fort Pierce, Fl. 34945 _
Property Tax ID q: 2309-800-0005-000-5 Lot No.
Sae Plan Name: _ Block No.
Project Name: Theresa Corbin
DETAILED DESCRIPTION OF WORK:
Install 14
:windows and c)
New Electrical Meter _ Second Electrical Meter—,__.. _ (Affidavit required)
I CONSTRUCTION INFORMATION:
Additional workto be performed underthispermit - checkallthatapply:
Mechanical Gas Tank _Gas Piping _Shutters 1LWindows/Doors _Pond
Electric _Plumbing __Sprinklers _Generator
Total Sq. Ft of Construction: _
Cost of Construction- $ 25,912
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Theresa Corbin
Name. Ronald heath
Address: 450 Campbell Rd
Company: Max Guard Hurricane Windows LLC
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No.772-971-0551
Address:2253 Vista Pkw_y, Ste 12
City: West Palm Beach State FI.
Zip Code: 33411 Fax:
Phone No 561-276-7100
E-Mail. tericorbin2(a.Jcloud.com
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Rheath(g-�)niaxguardhurricane.com
State or County License SCC131151738
If value of construction Is 2500 or more, a RECORDED Notice of Commencemenr is requnea.
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTALCONSTRUIETION 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.
1 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 hoklerto 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. Pease 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 buiiding permit applications are exempt from undergoing a full concurrency rev.ew: 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�a-�n.(attorney before commencingwork or recordingour Notice of Commencement.
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Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF &' - 1—,IC,i Q..
(or affrydl ndsubscribedbeforemeof ysicalPresence or— Online Notarization
Sw�odTthzQ 1, by
7 Qr e (� 1-�- �
Name of person making statement.
Personally Known OR Produced Identification
Type
Q�o\f`identification Produced /�
\ l�/�-r ` C-
(Signature of Notary Public- St to of Florida)
Commission No. Gc. �Qr1 (Seal) • L11 f:FN AicGRORY 5
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