HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-14-2021
Permit Number:
Iz-A971121V, -- - 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: WINDOW/DOOR INSTALLATION
PROPOSED IMPROVEMENT LOCATION:
Address: 9036 Champions WAY PORT SAINT LUCIE, FL 34986
Property Tax ID #: 3334-501-0047-000-4 Lot No. 33
Site Plan Name:
Project Name:
Block No. A
DETAILED DESCRIPTION OF WORK:
REPLACE 1 DOUBLE ENTRY DOOR AND 2 WINDOWS WITH NON -IMPACT. USING EXISTING SHUTTERS
INSTALLED UNDER PERMIT 1805-0652 USING LIK
New Electrical Meter Second Electrical Meter
� CONSTRUCTION INFORMATION:
ES, NO STRUCTURAL CHANGES BEING MADE
(Affidavit required)
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters V Windows/Doors ^ Pond
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 6,050
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
Name Robert K Kammel Sharon P Andre
Address:M36 Champions WAY _
city: Port Saint Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 772-403-3344
E-Mail: RKKAMMELeAOL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: BRUCE M. TYRRELL JR.
Company: Kamrell Windows & Doors
Address: 8200 SW LOST RIVER ROAD
City: Stuart State: FL
Zip Code: 34997 Fax: 772-288-6208
Phone No 772-288-6205
E-Mail Sue&Kamrell.com
State or County License CGCO61180
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 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.
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 o�r,/an attorneybefore commencingwork or recordingour Notice of Commencement.
7g.
Signature of Owner/ Legee/Contracif& as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of V Physical Presence or Online Notarization
this14thdayof December ,2021 by
Bruce M. Tyrrell Jr.
Name of person making statement.
Personally Known V OR Produced Identification
T pe of Identifica ion Produced
A _&WO.A�
(Signature of Notary Public- State of Florida )
,t r'r .. SUSAN MARIE GDDIA
Commission No. �= Notary Putslic . Statcommisslon
(Seal)
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Rev 5/20/21