HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INfF�OO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: - Ar Permit Number:
RECEIVED
Building Permit Application JUN 2 9 .2015
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 IMPROVEMENT LOCATION:
Address: 3965 OAK HAMMOCK LANE
Legal Description:
Property Tax ID#: 2429-233-0001-070-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE EXISTING WINDOWS AND S WITH IMPACT PRODUCT
��( a'JO0s �- /
CONSTRUCTION INFORMATION:
Acid itiona I work toe performed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 16,950.27 Utilities:Sewer E]Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name PAZIENZA&HALL LLC Name: ROY MICHAEL JOHNSTON
Address:5805 CASSIA DRIVE Company: STUART PAINT&SUPPLY
City: FORT PIERCE State:FL Address: 657 NE DIXIE HWY
Zip Code: 34982 Fax: City: JENSEN BEACH State:FL
Phone No.772 360-7133 Zip Code: 34958 Fax: 772 334-2705
E-Mail: Phone No. 772 334-2700
Fill in fee simple Title Holder on next page(if different E-Mail: MJOHNSTON@THEBUILDERSSTORE.NET
from the Owner listed above) State or County License: CGC 1517946
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION 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 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 roperty.A Notice of Commencement must be recorded and posted on the jobsite
before the fir I spe ion. If you intend to obtain financing, consult pith lender or an attorney before
commenci w r Virengdbg your Notice of Commencement.
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_Signat er/Lessee/Agent SiAaturentractor i e Holder
STATE OF FLORIDA STATE STATE OF FLORIDA
COUNTY OF !!1 4te'� COUNTY OFThe forgoing forgoing instru ent was acknowledged before me Theforgoing instru nt was acknowledged before me
this day of 20 _by this r�ri day of �(i!�0 _,20 by
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(Name of person acknowledging) (Name of person acknowledgin )
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(Si' atu�re f Notary Public-State of Florida) (qv/%otary Public-State of Florida)
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Commission N nsnooQ Exoo-aso8/22/2W816:0
8/22/2045
Revised 07/15/2014
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