HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR:AP.PLICATION TO.BE:ACCEPTED
.: � to
Date: :.:.Permit Number:: l
RECEIVED .' . :. .. .
'.ham ... .
OCT :0 7 2020
_ ..... Building Permit AppliCatidn .....
planning and Development5ervices 5t, Luc'i0 County
�errr�lttl�� .
Building and.codeRegulation Division .. :COmrnerciaJ... Residential.
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (7.72) 462-1553 Fax: (772) 4624578. .
:PERMITAPPLICATION FOR: -WINDOW/DOOR ..::.
PROPOSED IMPROVEMENT,LOCATION.. .
New Electrical Meter-:: Second Electrical Meter . (Affidavit: required)
CONSTRUCTIO N. I N FORMATION
Additiona[Work tobeperforrhed under this:permit:=check all that apply:.
_Mechanical. :-Gas Tank .. Gas Piping.. Shutters- X Windows/Doors .. Pond
Electric_: _ Plumbing.:.:.. . _ Sprinklers _ Generator- .:.:.._ Roof ::Pitch
Total,Sq. Ft:of Construction: Sq. Ft. offirst Floor:
Cost of Construction:,$ �?1 Utilities: Sewer _Septic,:: Building Height.
01NNER/LESSEE::,;
a :'
CONTRACTOR:
:Name Ronald :Buck Campbell:::-'.
Name: Alphonse .Campanelll . ':-
Address: 7900 San.Carlos, Dr.
Company:.:STORM TIGHT: WINDOWS..:.::
Address: 500; SW 12th:Ave:::
c�ly: Fort Pierce stale:.FL
Zip code: 34951 Fax:
city: Deerfield Beach state: FL
'Phone N.O.: (760) 529-2785:
Zip Code: .33442-- - Fax: (754) 227=789.1
E=Mail: rOnald.b.Carripbe110outlook.COm::
Phone.N:o (561) 420-0271.--
Fill in fee simpl.e:Title Holder on next page (if different
El -'Mail stormtightpe�mits@outlook.bom :::
'fromahe Owner listed.above):
State or. County License' CRC 046091
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
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
_
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 or an attornev before commencing; work or recording; your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORQ J_ J
COUNTY OF 45 Oj
Swor o (or affirmg�l a d subscribed bef me of � Physical Presence or Online Notarization
this � day of (J 2 by
I7
Name of¢:ierson making statement.
Personally Known OR Produced Identification
Tvue offldenfification Produced ,
gS&at"e f NotayPublic- State of FVorfida )
E1k
I�ATANYA00YKINCommission No. (Seal) Notaryrak-StateofFlatda.
Commission N HH 04131A
6tvXomm. Uplres Dec 20, 2024
iwtedd thnuth Natixwl Nadary Assn.
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