HomeMy WebLinkAboutBuilding Permit Application 4
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: t:r d is Permit Number: I M91
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
PERMIT APPLICATION FOR: �r .IkQ;l/JdaJS
PROROSED°INIPR01tMENTIOCATIdQN „ x
Address: 4837 Sears Street,Ft Pierce,FL 34981
Legal Description:PINE VISTA N 116.25 FT OF LOT 13
Property Tax ID#:2419-801-0018-000-0 Lot No.13
Site Plan Name: Block No.
Project Name:Jennifer Cruz or Juan Cruz-Robles
Setbacks Front Back: RlghtSide: Left Side:
DETAILER,DE5CRIPTION' OF WORK:'
Replacement of 3 windows M P A G
�
CON5TRUCTICN. IfV" RMATIONFO
itlona wor to a er orme under this permit—c ec a apply:]
❑HVAC E]Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑Plumbing ❑Sprinklers ❑Generator ❑Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5531.00 Utilitles:11Sewer❑Septic Building Height:
01111N ER%LESSEE CONTRACTOR
a .
Name Jennifer Cruz or Juan Cruz-Robles Name.Michele L.Diaz
Address: 4837 Sears Street Company:Storm Tight Windows,Inc.
City: Ft Pierce State: FL Address:1918 Corporate Drive
Zip Code: 34981 Fax: City:Boynton Beach State:F1
Phone No. 772-224-7807 Zip Code: 33426 Fax:561-292-3562
E-Mail: Phone No, 561-922-6747
Fill in fee simple Title Holder on next page(if different E-Mail:michele(a�stormtightwindows.com
from the Owner listed above). State or County License:CGC1515345
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPHPLEMENTMAL C�NSTRUCT.IQN LIEN`LAIN INFQRMATIQN'
x
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: 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 repre*entation that is granting a permit will authorize the permit holder to build the subject structure
W 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--pecording your Notice of Commencement.
(0100
Signature of`O:""er S4ge')Lessee Signature of Contractor/License H der
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF }tea/rn Bea C4, COUNTY OF
The forgoing instrument was acknowledged before me The forgoing ins rument was acknowledge ore me
this g day of.TGlne 20/rby this L day �-- 20 by
Ter2.p7/ ' r cn,Z
(Name of person acknowledging) {Name of person acknowledging}
(Signature bf Notary Public-State of Florida} (Signature of Nota Public-State of Florida}
TARy
Personally Known ✓ OR 4 �jeion Personally Known ✓OR Pry p Ideplification
Type of Identification Produce JV0__7.���at � Type of Identification Produce 00da
a�T4 Ue g T,gRyPu rrell
Commission No.FF/77loBledFla 147i�oFFzDue Commission No. • ' ' TjEOFFBLIC
�xAires;F1�j6 �A ��E 1�JI� FF177 SCA
Revised 07/15/2014 ulzorb /2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS