HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/11/22 Permit Number:
LML
bill
ti.,
n Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Window
PROPOSED IMPROVEMENT LOCATION:
Address: 31 Lake Vista Trail #206 —
Property Tax ID #: 3422-500-0433-000-4 Lot No._
Site Plan Name: Dan & Mary Hammond Block No.
Project Name: Hammond Windows
DETAILED DES RIPTION OF WORK-.
Replacing 10 Windows with Impact Rated Products
Picture Window PW-5520 NOA# 20-0401.16 Horizontal Roller HR-5510 NOA# 20-0406.01
Mull Bar NOA#20-0406.03
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 Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 15,374.00 Utilities: —Sewer —Septic Building Height:
❑WNER/LESSEE: CONTRACTOR:
Name Dan & Mwy Hammond Name: William H. Miller
Address: 31 Lake Vista Trail #206 J Company: O'Donnell Contracting LLC
City: Port St. Lucie State: FL Address: 1740 NW Federal Hwy
Zip Code: 34952 Fax: City: Stuart State: FL
Phone No. 772-971-7023 E- Zip Code: 34994 Fax:
Mail: Phone No 772-408-0200
Fill in fee simple Title Holder on next page (if different E-Mail odonnellpermitting-@gmail.com
from the Owner listed above) State or County License CGC035934
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:
City:
Zip:
Phone:
X Not Applica
State
X Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City. -
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone -
X Not Applicable
State:
X 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 holderto build the subject structure
which conflicts with any applicable Homeowners Association rules, bylaws or and covenants 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 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
i provements toy ur property. A Notice of Commencement must be recorded in the public records of St.
ci County and osted o the jobsite before the first inspection. If you intend to obtain financing, consult
it lender or attornevlbefore commencing work or recording your Notice of Commencement.
ignaYLP& of Owner/ L sse ee/Contractor as Agent for Owner
TATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this _ day of 20_ by
William H. Miller
Name of person making statement.
Pe rso ally Known X OR Produced Identification
e f Identificatio uced
( ignatu e f Notary ublic- State of Florida)
Commission No. (Seal) ! r y CornGlen
66562
B=W Thru AiiWFI 2I!+lotary
r
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 5/20121