HomeMy WebLinkAboutBUIDLING PERMIT APPLICATION�e�
All APPLICABLE INFO MUST E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q' SCANNED PermitNumber: (90q- 49Zr
BY
St. Lucie County
RECEIVED
a
Building Permit ApplicatiSh l s 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie county
2.3oo Virginla Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fait: (772) 462-1578 Commercial V Residential
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:
Address: 23 LAKE VISTA.TRAIL #105, PORT ST. LUCIE, FL 34952
Property Tax ID #: 3422-500-0313-000-7 Lot No.
Site Plan Name: Block No.
Project Name: DOUGLAS & ROBERTA EGER
DETAILED DESCRIPTION OF WORK: I
CONSTRUCTION INFORMATION:
Additional work to be performed underthispermit —check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric Plumbing _Sprinklers _Generator
Total Sq, Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 69820 Utilities: _Sewer _Septic
L/Wind6ws/Doors
Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameDOUGLAS & ROBERTA EGER
Name; SBPi� e�,
L atmlDEr'f
Address:23 LAKE VISTA TRAIL #105
Company: Newsouth Window Solutions
City; PORT ST. LUCIE State: FL
Zip Code: 34952 Fax:
Phone No.
Address:2526 Okeechobee Blvd.
City, West Palo Beach State:FL
Zip Code: 33409 Fax. 5614784100
Phone No 561-712-9000
E-Mail:
Fill In fee simple Title Holder on next page (If different
from the Owner listed above)
E-Mail]ennifeiraviles®newsouthwindow.com
State or County License .16*e+33#822-- SCC 131151
If value of construction Is 5250D or more, a RECORDED Notice of Commencement Is required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Not
Name:
City: State:
SIMPLE TITLE HOLDER: Not
Name:
Address:
City: _
Zip: ,
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Address:
I certify that no work or installation has commenced prior to the issuance of a permit.
Not
_Not
St. Lucie County mak, no repre ntration that is granting a permit will authorize the permit holder to build the subject sZucture
which is in conflict wins any app] ccable Home Owners Association rules, bylaws or and covenants that may restrict or pro !bit 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 concurrently review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentlal 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
i
Lessee 9gnature of=Y5 r/Llcense Holder
STATE OF FLO IDp STATE OF FLORI A
COUNTY OF 1 nn 6 P. (, h COUNTY OF Mtn 6car4
The forgoing instrument was acknowledged before me
this 52,�'-gy of PA a rcs 20 1-4-
by
OAUOlcts Cczer
{Name of pew Wo'nacknowledging)
mg )
/I
, 1A
.(Signature of Notfty Public- State of Florida)
The forgo�lag;�Instrument was acknowledged before me
this,2a Tayof Mrt((+.ir 20-.brby
L4
Personally Known OR Produced Identification. PersonallyKnown L/OR Produced Identification
Type of Identification Produced f Type of Identification Produced
Commission
Revised 07/15/2014
No.
o�,v'$�., JEN
�s%[\°4f-_State of
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
SUPPLEMENTAL CONSTRUCTION, LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _NotAp a
Name:
MORTGAGE COMPANY: _ Not Applicabl
Name:
Address:
Address:
City: State:
Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _NotAp
Name:
BONDING COMPANY: _NotAp '
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 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 exemptfrom undergoing afull 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF c(mNIENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/L cense Holder
STATE OF FLORIDA
STATE OF FLOgIp/�
COUNTY OF
COUNTY OF A rv� Pbea c h
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _ day of ,20_ by
thisl&nyof Apr,) 20 lgby
Name of person making statement.
Name of Person making statement.
Personally Known OR Produced Identification
Personally Known t--O0R Produced Identification
Type of Identification
Type of Identification
Produced
Produced
AVILES
JENNiFER
wn,,, Notary Public
'�"Y °b�:t: State of Floriddaa-- GG 196943
ae
(Signature of Notary Public -State of Florida )
(Signat of N =S �t9 9fiPMi�)iJ 2022
%q Marc
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19