HomeMy WebLinkAboutClark permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/20/2022 Permit Number:
L o G. L) tti -- - Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: James Clark
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 450261000090009 Lot No.
Site Plan Name: The Princess of Hutchinson Island Unit 109 Block No.
Project Name: James Clark
DETAILED DESCRIPTION OF WORK:
Remove and replace windows and doors with PGT
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 -V- Windows/Doors Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 1,350 Sq. Ft. of First Floor:
Cost of Construction: $ 18,694 Utilities: —Sewer —Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name James Clark
Name: Joe Delvecchio
Address: 9650 s Ocean Dr apt 109
Company: Monterey Glass
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 914-523-9328 E-
Address: 851 se Monterey Rd
City: Stuart State: FL
Zip Code: 34994 Fax: 772-283-1919
Phone No 772-521-4250
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail cliff.fischer@yahoo.com
State or County License 25686
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:
Name: _
Address:
City:
Zip:
Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
Citv:
Zip: Phone: _
Not Applicable MORTGAGE COMPANY: , Not Applicable
Name:
Address:
State
Not Applicable
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Citv:
Zip: Phone:
_Not Applicable
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 conflicts with any applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t with your Homeowners 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 Contractor - or - Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Florida
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this 20 day of January , 2022 by
Name of person making statement.
Perso ly Known x OR Produced Identification
Type Identificat' n Produced \\t�ttRff f
(Signature of Notary ul5 ic- state of Flores )
Commission No. HH026316 (Seal)_*' �•� :*�
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