HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: Permit Number: sc)vo
RECEIV-7D JUN 24 2015
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
PROPOSED CATI,O
111/hPROVEMENT LO ,N
Address: 9550 South Ocean Drive, Unit 102 Jensen Beach, FL 34957
Legal Description: Islandia 1 Condominium Unit 102 (OR 3488-2635)
Property Tax ID#: 4502-601-0001-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Newton-Islandia
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK N
t x w, t
Replace two non-impact sliding glass doors with two non-impact sliding glass doors
a
CONSTRUCTION INFORM4TION
. ` ,
Additional work toe erformed under this permit—c ec a appy:
0 HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
Electric D Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 7890.00 Utilities:Sewer El Septic Building Height:
OWNER%LESSEE ` CONTRACTOR x
F ;
Name Wesley&Kimberly Newton Name. Bruce M Tyrrell,Jr
Address:13775 9 Mile Road Company: Kamrell Windows&Doors
City.. Battle Creek State:MI Address: 241 SE Golfwood Drive
Zip Code:.49014 Fax: City: Stuart State:FL
Phone No.269-961-6016 Zip Code: 34996 Fax: 772-288-6208
E-Mail: N Phone No. 772-288-6205
Fill in fee simple Title Holder on next page(if different E-Mail: pati.kelvasa@kamrell.com
from the Owner listed above) State or County License: CGC061180
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN`LAW INFORMATION: ,...
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _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 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.
r
_Signature of Owner/Lessee/Ag t ignature of Contractor/Lice Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Martin COUNTY OF Martin
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_2a day of June 20 Eby this 23 day of June ,20 15 by
Bruce M1Tyrrell, Jr. Bruce M Tyrrell,Jr.
(Nameerson acknowledging) (Name of pe son acknowledging)
ignature of Nota P ic-State of Florida) (Signature of Nota ublic-State of Florida)
Personally Known_X OR Produced Identification Personally Known X—OR Produced Identification
Type of Identification Produced Type of Identification Produced
0,�,,0.Y..... AS
�/_ ,,%;;7y°°' PATRICIAA.KELVAS � 2: ; MY COMMISSION#FF08 6
Commission Now. ()$Syb � Se I II1
a? )Il1Y COMMISSION#FF08 410 mission No��� o��'t 7� I) EXPIRES:JAN 22,201
017 EXPIRE JAN 22,201 `a`.' '`�Bonded through 1st State Ins ice
Banded throu
Revised 07/15/2014
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