HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: �•��` ��`��
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Building Permit Application Qt, �Il ,p t
Planning and Development Services v ��rR?Il11Rq� itq
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Window/Door
PROPOSED IMPROVEMENT LOCATION:
Address: 1107 DRIFTWOOD LN, FORT PIERCE, FL 34982
Property Tax ID#.. 3404-808-0012-000-6 Lot No. 12
Site Plan Name: EASON Block No.
Project Name: EASON
DETAILED DESCRIPTION OF WORK:
— Replace existing windows/doors with impact. wWows
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 _X 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:
OWNER/LESSEE: CONTRACTOR:
Name William C & Karen E Eason Name: Alphonse Campanelli
Address: 1107 Driftwood Ln Company: STORM TIGHT WINDOWS
city: Fort Pierce state: FL Address: 500 SW 12th Ave.
Zip Code: 34982 Fax: city: Deerfield Beach state: FL
Phone No. (864) 977-1049 Zip Code: 33442 Fax: (754) 227-7891
E-Mail: wceason cni-_g mail.com Phone No (561)420-0271
Fill in fee simple Title Holder on next page( if different E-Mail stormtightpermits@outlook.com
from the 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 CONSTRUCT)ON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: V 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 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 attorrneey before commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
Pu" TIV.NGUYEN
STATE OF FLORIDA Commission#HH 037127
COUNTY OF (��J oe Expires August27.2024
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Swo n to(or affirmed) d s scribed before me of Physical Presence or Online Notarization
this IQ day of 267by
J r A M AS'O N
Name of person making stat ment.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Nota P lic- t e of Florida)
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Commission No. eal) _° ° Commission#HH037127
oe Expires August 27,2024
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
RECEIVED
DATE
COMPLETED
ev 5/20/21