HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /22 Permit Number:
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Windows
Commercial
CBDG Funding
PROPOSED IMPROVEMENT LOCATION;
Address: 8521 Hidden Pines Road
Property Tax ID #: 2323-701-0018-000-9
Site Plan Name: Randi & Phillip Letzelter
Project Name: Letzelter Windows
DETAILED DESCRIPTION OF WORK:
Replacing 5 Windows with Impact Rated Products
Single Hung SH-5500 NOA# 20-0401.03
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
(Affidavit required)
Lot No. 3
Block No. B
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: $ 7,766.00 _ Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
Name Randi Letzelter
Address: 8531 Hidden Pines Road
City: Fort Pierce State: FL
Zip Code: 34945 Fax:
Phone No. 561-573-3303 E-
ntail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Name: Michael O'Donnell
Company: O'Donnell Contracting LLC
Address: 1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No 772-408-0200
E-Mail odonnellpermitting gmail.com
State or County License CRC1331273
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.
t SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable I MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address: _
City: City:..
Zip: Phone: 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 conflicts with any. applicabie 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
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County a ted on the jobsite before the first ins . If you intend to obtain financing, consult
with lend r aplattornev before commencing wo recording our Notice of Commencement. of
ev
Signature of Owner/ Lessee/C ractvr as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn ❑ �r_�af�fi )and subscribed before me of %� Physical Presence or Online
Notarization
this�dd"y"of 20�6y
Michael O'Donnell
Name of person making statement,
Personally Known X OR Produced Identification
❑ dentification Pry uced
T tMkUuA
(Signature Notary Public- State of Florida)
Commission No. (Seal) ���,�/�� n