HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
c�t.��� a � O�- 00 5�
Date: Permit Number:
21ro
q 4_ WaF2"� W
RFQFIVED
P Building Permit Application JAN : �
2n22
13
Planning and Development Services
St,Lucl®County
Building and Code Regulation Division Commercial Residen l alarrnitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 10200 S OCEAN DR 407
Property Tax ID#: 4511-518-0035-000-5 Lot No.
Site Plan Name: Block No.
Project Name: ALBERT
DETAILED DESCRIPTION OF WORK:
REPLACE 1 SLIDING GLASS DOOR WITH IMPACT,
USING LIKE SIZES
NO STRUCTURAL CHANGES BEING MADE
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 Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 4337.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name James P Albert Anita Albert Name: BRUCE M. TYRRELL JR.
Address: 2 Norman Ct Company: Kamrell Windows & Doors
City: Dix Hills State: NY Address: 8200 SW LOST RIVER ROAD
Zip Code: 11746 Fax: City: Stuart State: FL
Phone No. 631-559-7459 Zip Code: 34997 Fax:772-288-6208
E-Mail: ALOOF330AOL.COM Phone No 772_288-6205
Fill in fee simple Title Holder on next page(if different E-Mail Sue&Kamrell.com
from the Owner listed above) State or County License CGC061180
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 or an attorney before commencing work or recording our Notice of Commencement.'
Signature of Owner/LessWe'ontractoeas Agent for Owner
STATE OF FLORIDA
COUNTY OF (
Sworn to(oraffirmed)and subscribed before me of `f Physical Presence or Online Notarization
this ") day of T6P1,QCj f'Ll 20 by
F)rore rn -r%4(re ll I'K
Name of person makings tement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public-State of Florida)
SUSAN MARIE GODDARD
4 Notary Public-State of Florida
Commission No.
(Sea[). a�e Commission#HH 033062
rti°*' My Comm.Expires Sep 25,2024
Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev
�;.i b..�..r6%i...R:_Laxi`.w..�K::�`hS,.�SP..�•'-aFaA:n.-�w,..c-.w...,'.