HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��— /� Permit Number:
Building Permit Application
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 Residential X
PERMIT APPLICATION FOR: Window/door
PROFOSED:;INIPRQVEMLNTLOCATIC3N ..,.. . ,_ _ . . . ...x,. . . . . " _,
Address: 15 Majestic Way, Ft. Pierce, FI 34949
Legal Description: QUEENS COVE UNIT i -BLOCI'18 LO'T C
Property Tax ID#: 1414-701-0171-000-5 Lot No. C
Site Plan Name: Block No. 18
Project Name: GaryArmentrout
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF V1/ORIC
71
CONSTRUCTION INFORMATION
w
Additionalwork toe e Orme under this permit—,heck a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric ❑ Plumbing []Sprinklers Generator Roof
Total Sq. 1 t of Construction: S ,-L.Of First Floor: _
Cost of Construction:$ 5269.00 Utilities:L Sewer El Septic Building Height:
OWNER/LESSEE CONTRACTC3R
mss, `•S �� �� ,!� Ham, .ter aa. ' s �;., N.r,�
Name Gary Armentrout Name: Scott Berman
Address: 15 Majestic Way Company: Florida Window&Door
City: Ft. Pierce State: FL Address: 7108 Fairway Drive# 120
Zip Code: 34949 Fax: City: Palm Beach Gardens State:FL
Phone No. 772-801-5957 Zip Code: 33418 Fax:
E-Mail: Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different E-Mail: howard@floridawindowanddoor.com
from the Owner listed_above) State or County License: CGC1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C NSTR`l1CTIQN UE LAW 1NF RMATION ' x
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x—Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thepermit 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
commencing work or recording our Notice of Commencement.
S
_
Signattire pif Owner116ssee/Agent Signature of ContflEtortticense Holder
STATE OF FLORIDA nn STATE OF FLORIDA
COUNTY O V�� COUNTY OF Palm Beach
The forgoing instrument was acknowledge .before me The forgoing instrument was acknowledged before me
this day of (Y10tr 'Irl 20 1, this day of 20 Lby
1 Scott Berman
(Name of p son acknowledging) (Name of person acknowledging)
lgnatur of o ary 13611k! State of Florida) ( lgnature of Notary Public-State of
Personally Known OR Pl;aduce4Identification Personally Known x OR Produced Identification
Type of Identification ProducedType of Identification Produced
HOWARD SIMKOFF
Commission No. �d al ERIKA {pomml ion NoE6g'k'7�y *� ePAY COMMISSION#EE 830
Notary Public,State f Florida EXPIRES:August 27,20
N�'Te`�o�°P Bonded Th
MY comm.expires Aug.10,2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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