HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: 3/15/18 SCANNED Permit Number: 1101. ON o
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at. Lucie County at'Eb
Building Permit Application -Jul. 80?91#
Planning and Development Servicesrphent
Building and Code Regulation Division ty
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 10200 S OCEAN BLVD UNIT 410
Legal Description: ATLANTIS III BY THE SEA UNIT 410
Property Tax ID #: 4511-518-0038-000-6
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
REPLACE 2 OPENINGS OF WINDOWS WITH PGT ALUMINUM IMPACT WINDOWS
CONSTRUCTION INFORMATION:
Itlona worK to IDe � rtormed under tispermit—check all apply:
�HVAC LJ Gas Tank Gas Piping _ Shutters Windows/Doors
Electric ElPlumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ 6,871.03 Utilities: Sewer DSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name ARGERO KAMMLER
Name: ROY MICHAEL JOHNSTON
Address:10200 S OCEAN DRIVE UNIT 410
Company: STUART PAINT & SUPPLY
City: JENSEN BEACH State: FL,
Zip Code: 34957 Fax:
Phone No. 772 229-0551
Address: 657 NE DIXIE HWY
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: 772 334-2705
Phone No. 772 334-2700
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: mjohnston@thebuildersstore.net
State or County License: CGC 1517946
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/jjNGINEER: _ Not Applicable
Name:' VaV) Geel(A
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:,% fly R,71�rrC{ S4 �l
Address:
GeSt
Citylp � rf C{ e State: FL
Zip: — Phone 24 7 S- U&S
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 authorizethe 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 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, consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement. Ap,
1140111
Signat a of Owner/ Lessee/Contractor as Agent for Owner
Sign ture of Contractor/License Holder
STATE OF FLORID '
STATE OF FLORIDA /
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COUNTY OF 1
COUNTY OF �%i
The forgoing mstrupentwas knowledge] efore me
this � b day of 20j by
The &innstrum t was acknowledged before me
thisof 20�&by
lb' ol�A Y 1 Ga ern n Y. X�
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Ndme of person ny�king statement
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N e of person mak'ng statement
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Personally Known OR Produced Identification
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
Produced
% �/� tY 1 4 M
Notary Public- State FI 'da
(Signature of Nota Public- S a o F i
(Signature of of )
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17