HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 ��
Date: Permit Number. 1 ® �
RECEIVED
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BuildingPermit Application DFr.
p p !Permitting Department
Planning and Development Services St. Lucie CQ my
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 CBDG Funding j
PERMIT APPLICATION FOR: WINDOWS/DOORS
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PROPOSED IMPROVEMENT LOCATIQN;1950 Cortez,BL`!'b Fort Pie, FL 34982; ..,,
Address: 1950 Cortez BLVD Fort Pierce, FL 34982
Property Tax ID#: 2421-607-0014-000-3 Lot No.3
Site Plan Name: Block No. B
Project Name: GOLDBERG
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DETAILEDDESCRIPTION OF WORK: '
j REPLACE EXISTING WINDOWS/'WITH IMPACT
10 1"
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New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply: Vwindo
Mechanical Gas Tank Gas Piping Shutters ws/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 21,500 Utilities: _Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR
Name Shirley A Goldberg Name: ALPHONSE CAMPANELLI
Address:_1950 Cortez BLVD 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.(772)579-0714 E- Zip Code: 33442 j Fax:
Mail: N/A Phone No 800-249-4240 ext 913
Fill in fee simple Title Holder on next page(if different E-Mail stormticihti)ermits(cDoutlook.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.
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5UPPtEMENTAL CONSTRUCT ON:LIEN LAW INFORMATION R E�
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DESIGNER/ENGINEER: V Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: 1 State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: ! _V Not Applicable
Name: Name:
Address: Address:
City: City: i
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 restrictidns 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 Amendment is.
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
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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.
Signa ure of Owner/ ssee/Contractor as Agent r Owner
STATE OF FLORIDA ��
COUNTY OF
Sworn to(or affirmed)and subscribed beforgg me of Physical Presence or Online Notarization
this 11 day of 20�,Iby
Name of person making statement. '
19tlpff6jv�'e ci'M �'40e-16
Personally Known J —OR Produced Identification
Type of Identification Produced
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(Signature of Notary Public-State of Florida) ���Y Nick Nettles
Commission No. }����6 (Seal) a NOTARY PUBLIC
a _STATE OF FLORIDA
a Comm#GG22414is
'`1''tCe,v Expires 6/13/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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