HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
15 c D� c L k 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: IMPACT WINDOWS AND DOORS
PROPOSED IMPROVEMENT LOCATION:
Address: 7313 ELYSE CIRCLE
Property Tax ID #: 3416-801-0036-010-9
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL IMPACT ( ) WINDOWS AND ( ) DOORS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 16
Block No. C
Additional work to be performed under this permit —check all that apply:
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name DAMES GRAVELINE & STACEY PARRISH
Address: 7313 ELYSE CIRCLE
City: PORT ST LUCIE State: _
Zip Code: 34952 Fax:
Phone No. 954 557 2978
Name: MADELYN GUZMAN
Company: WRIGHT'S IMPACT WINDOW & DOOR LLC
Address:7816 S. DIXIE HWY_ _,,
City: WEST PALM BEACH State: EL
Zip Code: 33405 ¢ Fax:
Phone No (561) 588-7353
E-Mail: fortlaudff@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Permit@wrightswindow.corn
State or County License CBC1262617
It 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
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 installation
and as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit.
St.
is Inc onilict with any applicableiHo that
aOwners Pssociationirulesabylaws or andpcovenantsthatmay prohibit such
restrictborr
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 attorney before commencing work or recording our Notice of Commencement.
duJNEJ.1
Signature,171Owner/ Lessee/Contractor as Agent for Owner
Signat a of ntra or/Lic r Holder
STATE OF FLORIDA
STAT OF FLORIDA
COUNTY OF 5 1. Z> > i cS
COUNTY OF reim�ea
Swo to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
thGGi day of J1 ��y_y>,,2020 by
Ph sical Presence or Online Notarization
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this�dayof SGy7 16A&M,by
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MADELYN GUZMAN
Name of persion making statement.
Name of person making statement.
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Personally Known xx OR Produced Identification
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