HomeMy WebLinkAboutBUILDING PERMIT APP-SIGNEDAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/03/2022 Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential V
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 4949 N HIGHWAY A1A 181
Property Tax ID #: 1414-602-0068-000-6 Lot No.
Site Plan Name: Block No.
Project Name: SAENZ
DETAILED DESCRIPTION OF WORK:
—REPLACE 2 WINDOWS AND I SLIDING GL8SS 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 Constructions: Sq. Ft. of First Floor:
C
Cost of Construction: $ 1 J Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name AL & JO-ANN SAENZ Name: BRUCE M. TYRRELL JR.
Address: Company: Kamrell Windows & Doors
City: FORT PIERCE State: Address: 8200 SW LOST RIVER ROAD
Zip Code: 34949 Fax: City: Stuart State: FL
Phone No. 954-647-9 1 48 Zip Code: 34997 Fax: 772-288-6208
E-Mail: ALSAENZ83 GMAIL.COM Phone No 772-288-6205
Fill in fee simple Title Holder on next page ( if different E-Mail
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
Name:_
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:_
Address:
City:_
Zip:
Phone:
State
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:_
Not Applicable
State:
BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
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 your Notice of Commencement.
Signature of Owner/ LesseefContractor aogent for Owner
STATE OF FLORIDA
COUNTY OF
MARTIN
Sworn to for affirm d and subscribed before me of
this day of f 20 by
BRUCE M TYRRELL JR.
Name of person making statement.
Personally Known N� OR Produced Identification
Tyne of Identification Produced
re
Commission No.
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
Physical Presence or Online Notarization
State of Florida )
SUSAN h1ARiE G4004LR0
(Seal) F; Notary public State ai Florida
commission # SH 033062
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Bonded through National Notary Assn.
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