HomeMy WebLinkAboutBLDG PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LLILY CIE
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 4610 MAGNOLIA DR
Residential XX
Property Tax ID #: 3402-605-0020-000-6 Lot No. 51 6,7
Site Plan Name: NDIAN RIVER ESTATE S-U N IT-04- BLK 33 S 10 FT OF LOT 5 AND ALL LOTS 6 & 7 Block No. 33
Project Name:
INSTALL IMPACT ( 13 ) WINDOWS
New Electrical Meter Second Electrical Meter
it
. . ... ...
Additional work to be performed under this permit —check all that apply:
Mechanical _Gas Tank Gas Piping Shutters
Electric Plumbing Sprinklers Generator
Total Sq. Ft of Construction:
ZZ,�Cost of Construction: $ p�J .
Windows/Doors
Roof
Sq. Ft. of First Floor:
Utilities: Sewer Septic
Building Height:
Pond
Pitch
Name Douglas J Lane
--- ---- ----------
Name: MADELYN GUZMAN
Address: 4610 MAGNOLIA DR
Company: WRIGHT'S IMPACT WINDOW& DOOR LLC
City: FORT PIERCE FL State:
Address:7816 S DIXIE HWY
Zip Code: 34982 Fax:
City: WEST PALM BEACH State: FL
Phone No. 772 359 8547
Zip Code: 33405 Fax:
E-Mail: suelane4610@)gmail.corn
Phone No (561) 588-7353
Fill in fee simple Title Holder on next page if different
E-Mail permit9wrightswindow.corn
from the Owner listed above)
State or County LicenseCBC1262617
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.
77
WAN
� " � � T AL CONSTRUCTION LIEN LAW F
tic `�7 �r .
DESIGNER/ENGINEER: Not AnnlicahlP
Name:_
Address:
City.
Zip:
Phone
State:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zi p: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip:
Phone:
BONDING COMPANY:
Name:
Address:
City•
Zip: Phone:
Not Applicable
State:
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 is in conflict with any applicable Home Owners Association rules bylaws or and
y covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and reviewcov na
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 attorne before commencing work or recording your Notice of Commencement.
Signat re of Contrac or/License Hold r
Signature of Owner/ Lessee/C6�tractor as Agent for Owner
STATE OF FLORIDA:
STATE OF FLORIDA
COUNTY OF — '`I -
COUNTY OF PALM BEACH
Sworn to (or affir s and �.ubscribed ,More me of
Sworn to or affirmed and subscribed before m
( } e of
, !,,
Physical Pres -dr Online Notarization
x Physical Presence or Online Notarization
this r day of < 6 , 2W by
this day of 2022 24�W by
MADELYN GUZMAN
c
r
Name of per n making statement.
Name of person making statement.
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S
O .�.C
Personally Known OR Produced Identification
Personally Known xxx OR Produced Identification
� cm
�ti
Type of ldentifeption
Type of identification
= . _ ..
Produced
Produced
.S .C? !r
a �
� oL E
(Signature of N_aryYibli
St�'raf FloricS E P H G O M E Z
(Signature of Notary Public- St e of Florida)
�o
Commission No. C
Notary Public -State of Florid
=*,. C; m' ;;ion # HH i 80416
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nmission Expires
f,o11�`
ommission No. _ (Seal)
#«
November 16, 20?5"r
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