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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEP'
Date: _ Permit
AID .0010
• Building Permit Application
Planning and Development Services
I
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ( Residential
PERMITTYPE: poor
I PROPOSED IMPROVEMENT LOCATION: I.
Address: 9440 Meadowood Drive Apt. 201 Ft. Pierce, FL 34951
Property Tax ID #: 1327-703-0019-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
liding door replacement
CONSTRUCTION INFORMATION: 1101
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_Electric _Plumbing _Sprinklers _Generatl
Total Sq. Ft of Construction:
Sq. Ft. of First FloorI
Cost of Construction: $ 1200 • o o Utilities: Sewer —SE
I
Lot No.
Block No.
_ Windows/Doors
_ Roof Pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR: 1
Name Damon C Pouyat
Name: Gary Whighain
"
Address: 9440 Meadowood Drive Apt, 201
Company: South Florida Aluminum Products
City: Ft. Pierce State: _
Zip Code: 34951 Fax:
Phone No.51-441-0779
Address:4807 So US
Hwy 1
City: Ft. Pierce I State: FL
Zip Code: 34982 I Fax: 772-466-1074
Phone No 772-466-0913
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail sfapbooks(Osoflalum.com
State or County LiclensL y7 7/
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:
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: j—
Name:
City:
Zip:,
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: I State:
Zip: Phone:
Not Applicable I BONDING COM
Address: I
City:
Zip: Phone:
_Not Applicable
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in coNict 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 fall 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
i
"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
POSTEf��Q(1N THFE�JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIT; 0,2 LADL* OR AN ATTORNEY BFFORCRECORDING YOUR NOIIEE�ENCEMENT."
1/
Sit!!ywaf essee/Contractor as Agent for Owner
Signature older
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF �� Lu GI
COUNTY OF <]` l u c.t !�e
The forgoing instrument was acknowledged before me
The forgoing instrument was qcknowledged before me
this 4-- day of /U/ IAD 1 Qw . 20_4 by
this —,L- day of 1204 by
i
CG1`I Lk%ie_ 6,1,,__
LI—A IUhh&z..,�
Name of person making s[ ment.
Name of person making statement'.
Personally Known OR Produced Identification
Personally Known✓/ OR Produced Identification
Type of Identification
Type of Identificatio
Produced
Produced
(Signature f D Pu@UiA186sGFNNFIM41%�bNTI
(Signet
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_ ': tv1Y COMMISSION U/ 3138
V MARY ANN. I
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Commissiol ... 7
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"'%torv;o,; I EXPIRES January 24. 2020
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