HomeMy WebLinkAboutBuilding Permit Appl. - GessleyAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/3112022 Permit Number:
L? 4 ii Building PP 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 CBDG Funding
PERMIT APPLICATION FOR: Gessley, Debora
PROPOSED IMPROVEMENT LOCATION:
Address: 3213 Live Oak Ln. Ft. Pierce FL 34981
Property Tax ID #: 2430-502-0048-000-6 Lat No. 48
Site Plan Name: Block No.
Project Name: Gessley Window Replacement
Replace existing windows with impact rated windows.
New Electrical Meter Second Electrical Meter (Affidavit required)
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters X Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 12,322 Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Gesslev. Debora
Name: Ron K[offlhout
Address: 3213 Live Oak Lane
Company: Ronald Kromhout General Contractor, Inc.
city: Ft. Pierce State: FL
Address. 4500 5th PI SW
City: Vero Beach State: FL
Zip Code: 34981 Fax:
Phone No. 305-393-3128 E-
Zip Code: 32968 Fax:
Phone No 772-473-4597
E-Mail_ kromhoutronQgmail.com
Mail:_ dgessley0b-aol.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CGC 023856
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 tAW 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:
City:
Zip: Phone:
Zip: Pion:
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 grantinga permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Associaion rules, bylaws or and cover ants that may restrict or prohibit such
structure. Please consult 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 1 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 polling 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
"1*2MAI.al exxcx lArm �
Signature of Contra r -or -Owner Builder as applicable
STATE OF FLORIDA
COUNTY OF Indian River
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this 3jatday of janllary _ 20 22 by
Name of person making statement.
Personally Known X OR Produced Identification
Type I ntificativ Produ
(Signs ure of Notary Public- State of Florida)
Commission No. GG 974950 (Seal)
,,, ,,,
CHERiE L. BRUMIT
, �'" ,
Notary Public -State of Florida
commission # GG 974950
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My Comm. Expires 04-OS-2024
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Bonded Tnrouph
Notary Public Cnderwriters
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Rev 10/12/21