HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3�� �d Aiuno alon Permit Number:
1 '18 =RECEIVED• a3NNVD.qBuilding Permit ApplicationPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Window/door n III
PROPOSED IMPROVEMENT LOCATION:
Address: 9600 S OCEAN DR 1504
Legal Description: EMPRESS CONDOMINIUM UNIT 1504
Property Tax ID #: 4502-620-0112-000-5
Site Plan Name: THE EMPRESS CONDO
Project Name: KELLY RESIDENCE
Lot No.
Block No.
Setbacks Front Back: Right Side: Left Side: II
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE (2) SINGLE HUNG WINDOWS AND (2) SLIDING GLASS DOORS WITH
IMPACT.
I CONSTRUCTION INFORMATION: III
MUUILIVI141 WUI R w ue Pen un neu unuei unb perrnu— Lnecx au apply:
[1HVAC Li Gas Tank ❑Gas Piping In _Shutters ✓Windows/Doors
11 Electric 0 Plumbing Sprinklers E] Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 16,000.00 Utilities:cn Sewer OSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Daniel J Kelly 8 Kathleen T Kelly
Name: David LaPrade
Address:9600 S Ocean DR Apt 1504
Company: The Glass Professionals
City: Jensen Beach- -State: FL
Zip Code: 34957 Fax. N/A
Phone No.630-379-6774
Address: 3570 SE Dixie Hwy -
City: Stuart State:FL
Zip Code: 34997 Fax: 772-286-0461
Phone No. 772-286-0459
E-Mail: misterolab@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: permits.glasspros@gmail.com
State or County License: 19363
It value of construction is 52500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:,
MORTGAGE COMPANY: _ Not Applicable
Name:'
Address:
Address:_
City: State:
Zip: Phone
City: stuan State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Address:
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 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,
accessary 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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, co�su tt lerider or an attorney before
commencing va5k'or recording vour Notice of Commencemxmu \ (1 '--�
for Owner
STATE OF FLORIDA STATE OF COUNTY OF frdr4i (1 COUNTY OpORI
V f'a rki n
The forgoing instrument was acknowledged before me
this,ci day of .:o)ubt-4 , 20 lb by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification r
Produced F�l- y 400 I-785/ /(pS-'b
The forgoing instrument was acknowledge before me
this-adayof oillimrT 20 Gby
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
ProducedE�J, M (735 (11(0 j - Q
(Signature of fTotary Public
nature of Ngtajy Public- State of FI ri a
Commission No. �i
KELLY WIOMAN
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• YPUB��:'z Y Public -State of Fln5�
`J �����•. - KELLY viln!JAN
• •, _( FF 9292
, °a Ndt��01,bhc.- State of Florii
mission No. c`'�'Jt°6°<;.,Commission#
My Comm. ExpiresOct 20,
• : : • Commission # FF 929255
•%°F`O•� edthrou hNatlonal Notar
- - 's'�„ ;� My-Canim. Expires Oct 20, 21
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Rev. 8/2/17
"I" KELLY
f' + "A Notary Public SteA state " Of Florida
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