HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
` Permit Number.
Date:
RECEIVED
9IT" MAR 2 9 2022
o 6)� HFOIO i3�1f1ty
° ^ ' Building Permit Application @ Rho
Planning and Development Services
Building and Code Regulation Division - COfnmercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: IMPACT
PROPOSED IMPROVEMENT LOCATION:.
Address: 13239 NW HARBOUR RIDGE BLVD
Property Tax ID#: 4425-604-0012-000-8
Site Plan Name:
Project Name:
DETAILED DESCRIPTION. OF WORK:
NSTALL IMPACT ( ) WINDOWS
New Electrical Meter Second Electrical Meter
Residential XXX
) WINDOWS
Lot No.
Block No.
CONSTRUCTION, INFORMATION -
Additional work to be performed under this permit —check all that apply: /
_Mechanical _ Gas Tank _ Gas Piping _ Shutters VWindows/Doors _ Porid
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
�� "w �pd f
Cost of Construction: $ lQ 39 Ste_ Utilities: _Sewer —Septic Building Height:
OWNER/LESSEE'` a
Name Robert A & Beth Ann Aftenkirch
Address:13239 Harbour Ridge BLVD
City: Palm City State:
Zip Code: 34990 Fax:
Phone No. 256 513 1417
E-Mail: bethaltenkirch@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
'RACTOR:
MADELYN GUZMAN
CompanwWRIGHT'S IMPACT WINDOW & DOO
Address:7816 S DIXIE HWY
City: WEST PALM BEACH S
Zip Code: 33405 Fax:
Phone No(561) 588-7353
E-Mail Permit@wrightswindow.com/
State or County License _CBC12P'
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: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners 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 attornev before commencing work or recording vour Notice of Commencement.
Awa (&".
-
q 0- A��S-4 I,,- C-
Signature of Owner/ Lessee/Contractor as Agent for Owner
of Contract License Hor
SignaturIFr
STATE OF FLORIDA
STATE FLORIDA
1
COUNTY OF swx Cl`C-
COUNTY OF PALM6EACH
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and sub before me of
V, Physical Presence or Online Notarization
-scribed
xxx Physical Presence or �W Online Notarization
this Q day of 202fty
this / f day of g� 21M , 2020 by
CL LL n 1'.k�
MMELYN GUZMAN
Name of person making statement
Name of person making statement.
Personally Known �(- OR Produced Identification
Personally Known xxx OR Produced Identification
Type of Identification
Type of Identification
pro
Produced
re of N ,•,�,,fil�c- Statd.Yi6 INGER
(Signat a of Notary Public- Sta
x Notary Public State of Florid
Sullivan
2°: �•�� Notary Public •State of Florida
y a; Commission # �i9�21 02
`
Commission No. S o GG 929907
C mISSIOn NO. ? F:' m. Expire9�a 2023
3�Commission
or M1 Expires 1110612023
" Bonded through National Notary Assn.
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Rev. 5