HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u
X5115
PermitNumber:
Date: GI r.
• RECE11.17D JUN25 2095
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
PROPOSEDIM,PROVENIEiVT LOCATION:.
Address: 17 Castle Court, Ft. Pierce, FL 34949
Legal Description: Queens Cove-Unit 1 BLK 19 LOT F (Dp agg3_a99 ; q 3 i — ay.9 3GJ(o-7U7)
Property Tax ID#: 1414-701-0189-000-4 Lot No. F
Site Plan Name: Block No.
Project Name: David Baselice
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION;
ESCRIPTION OF WORK. ''...
Jn,S+olj d )mPac4 ou4swink cla-yrs, 3 imPac� Sliclinc�5 lass C/0ors an C/
17 ilnPac4 �i��o��,
CQNSTRUCTION'INFOR{UAT(ON
Additional work to be nertormed under this permit—c ec a t t appy:
1_1HVAC l_I Gas Tank Gas Piping _Shutters Windows/Doors
Electric F-1 Plumbing [:]Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 24,834 Utilities: Sewer 0 Septic Building Height: MR14 15'
,-,OWN ER/LESSEE :CONTRACTOR::
Name David Baselice Name: Scott Berman
Address:17 Castle Ct. Company: Florida Window and Door
City: Ft. Pierce State:FL Address: 7108 Fairway Drive, Suite 120
Zip Code: 34949 Fax: City: Palm Beach Gardens State:FL
Phone No. Zip Code: 33418 Fax: 50- 6,9V:SLC 37
E-Mail: Phone No. 561-340-4300 r
Fill in fee simple Title Holder on next page(if different E-Mail: how aI'd( ELc i('whin clot %c&n !Cl rn r, co
from the Owner listed above) State or County License: CGC 1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
-SUPPLEMENTAL CONSTRUCTION LIEN CAW 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: V 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 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 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.
C S
_Signature of Owner/Lessee/ gent Signature o ctor/License Holder
STATE OF FLORIDA STATE OF FLORID �_ �
COUNTY OF COUNTY OF n/riQ /�c n.0
The forgoing instr as acknowledged efore me The rgoing instrument was acknowledged before me
this day of 20 (�by this day of 20 L by
David Baselice 1 Scott Berman
(Name erson ack owledging) (Name of person acknowledging)
I ure of Nota li ate of Florida) Ifignature of Notary Public-State of Flori
Personally Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification-Eroduced Type of Identification Produced
°tpRY PUe�ic HOWARD SIMKOFF
Commission No. [ Commission N (�eWtOMMISSION#EE 830795
EXPIRES:August 27,2016
?` a JENNIFER
• = sfer oe`O� Banded Thru Budget Notary Services
W"'O
a rY ublicState cl Florida
Revised 07/15/2014 M Coomm.Expires Oct30,2016
mission#EE 84
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