HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I - k l fl — Q rA Permit Number:
IN114ru
BY
:0MOMMM, —rI St. Lucie County
Building Permit Applicatio
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Reside
PERMIT TYPE:Window Replacement
PRO Pb S ED�"[ M IPR OVE M�XT ON-;,.
Address: 3501 Shinn Road
Property Tax ID #: 2330-311-0001-000-2
Site Plan Name:
Project Name: SLC Ft. Pierce Fire Dept
Replace 17 Windows —
1"CO NSTI-RU CT-1,04-1 N'FbRMATI'O. , N:
Additional work to be performed under this permit— check all that apply:
—Mechanical — GasTank Gas Piping — Shutters
— Electric — Plumbing Sprinklers — Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 11,500.00 Utilities: —Sewer _Septic
AUG 16 2019
sT. Lucie County, Permitting
Lot No.
Block No.
—Windows/Doors
Roof Pitch
Building Height:
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U AyT�QR,:
NameSLC Ft. Pierce Fire Dept
Name: Ray Reinhard
Address: 5160 NW Milner Drive
Company;HBS, Inc.
City: Port St. Lucie State:
Zip Code: 34945 Fax:.
P ho n e N 0. 772-216-6510
Address:722 3rd Place
City: Vero Beach State: FL
Zip Code: 32962 Fax; 772-778-3514
Phone N0772-567-7461
E-Mail: sientz@slcfd.org
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail tammy@hbsglass.com
State or County LicenseSCC131151281
If value of construction is $2500 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.
-ICO
DESIGNER/ENGINEER: Not Applicable
Name:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
ORMATIOR:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City:
Zip: —
Phone:
BONDING COMPANY: —Not Applicable
Name:
Name:
Address:
Address:
City:
City:_
Zip: Phone:
Zip: —
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 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_0J3TA1N FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NO111elITMEOR&ONCEMENT."
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3ignat e LesseelContra Tto��Agent for owner
,�A of Mri Lessee/Con1t
Signalure of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFft"--ftvur54--Lq6-e_
COUNTY OFInclani'liver
The forgoing instrument was acknowledged before me
The forRx . ing instru7pnt was ack owledged before me
of )9-u5i 20
this ff day -La by
this -ij-day of :9 20ig by
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J_OeL� CC?_-.5C2)r-)
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Name of person making statement.
Name of pirson making sta ent.
:OR
Personally Known �,/ OR Produced Identification
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
Pro uce
(SignatuWof Notary Pu I! 01(EI;16nagh�00
-('§Vature of N W Publi Florida)
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Commission No. Expires er 15, 2020
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Notary Public State of Florid
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