HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
91 r.C,(:J CtLL ,
Building Permit Application
Planning and Development Services
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:James Fitzpatrick
PROPOSED IMPROVEMENT LOCATION:
Address: 12813 NW Cinnamon WAY
Property Tax ID#: 4425-602-0018-000-4 Lot No.37S
Site Plan Name: Fitzpatrick Block No. 40E
Project Name: Fitzpatrick
DETAILED DESCRIPTION OF WORK:
Replcement of Windows and Doors with Impact
New Electrical Meter Second Electrical Meter
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: $ 9,000.00 Utilities: —Sewer _Septic Building Height:
fAddress:
WNER/LESSEE: CONTRACTOR:
meJames Fitzpatrick Name:Jeffrey Walsh
12813 SW Cinnamon Way Company:Liberty Impact Windows and Doors
City: Palm City FL State:— Address:257 SE Monterey Road East
Zip Code: 34990 Fax: City: Stuart State:FL
Phone No,772-444-7112 Zip Code: 34994 Fax:
E-Mail: Phone No 772-444-7112
Fill in fee simple Title Holder on next page if different E-Mail t
from the Owner listed above) State or County icense CG 52 257
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: X 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: Cit,;:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installationas indicated.
1 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 YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE RE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER ATTORNEY BEFORE RECORDING YOUR IVOTICE OF COMM :°
Signature of ner/Lessee/Contractor as Agent for Owner Signature of C tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF AA A 2'T k tJ COUNTY OF IV/-\C_T I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2ti�day of ��r--�v�2:-i ,202 2 by this `T�cfay of TP 20L_2-by
5 C l ( 2Er�4 yJLi� —SG CF w NL—
Name of person making statement. Name of person making statement.
Personally Known OR Produced identification Personally Known � OR Produced Identification
Type of Identification A�4a HM Type of identification J.Hill
AkioProduced Produced
NOTARY PUBLIC NOTARY PUBLIC
STATE OF FLORJ bA STATE OF FLORID
Commit GG9491 _ Cwvn#GGS49120
�--�" -Expires 3/29/2024
(Signature of Notary Public-state of Florida) (Signature of Notary Public-State of Fir a)
Commission No. G C-P 1-2 C (Seat) Commission No.C-1(ft (Sea{}
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW _ REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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