HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. `,�j(
Date: j �� 1� Permit Number: '`'" " ` J
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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)462-15,78 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 710 SE Hidden River Drive
Legal Description: Hidden River Estates Block 3, Lot 3
Property Tax ID#: 3427-701-0038-000-7 Lot No.3
Site Plan Name: Block No. 3
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of(2) 4 X 6 Thermal pane impact glass single hung windows
located in front of home
CONSTRUCTION INFORMATION:
Additional work to be nertormed under tispermit—check all fn appy:
HVAC Gas Tank ❑Gas PipingMGenerator
Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers F] Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1,350.00 Utilities:cnSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Dolores Payne Name: Vincent Montalto
Address:710 SE Hidden River Dr. Company: Vincent Montalto Construction
City: Port St. Lucie State:Fl Address: 414 SW Dalton Cr.
Zip Code: 34983 Fax:772 489-9126 City: Port St. Lucie State:FI
Phone No.772 878-1722 Zip Code: 34953 Fax: '771- 3q k—_3,3f @-
E-Mail:DZGZ900@aol.com Phone No. 772 370-1127
Fill in fee simple Title Holder on next page(if different E-Mail: ln�tkV.-wiz aV (? ly I�AIZ�
from the Owner listed above) State or County License:
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 property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. I tend to obtain financing,consult with lender or an attorney before
commencio&workX recor ' g you-rVotice of Commencement.
s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SL Lucie COUNTY OF St.Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_[L day of uS,f' 20/6 by this 11"' day of August 20 by
Vincent MontaltoEE Vincent Montalto
(Name of person acknowledging) (Name of person acknowledging)
Jan�,&
(Signature of Notary Public-St a of Florida) (Signature of Notary Public-Stat of Florida)
`p��tYPUB.,� Danielle Biglin
Personally Known x OR Produced Identification Personally Known X OR a Idef TIMMMO107315
Type of Identification Produced Type of Identification ProduceAf EXPIRES:AUG.25,2015
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Commission No. EE107315 Wiz' Q CftigA'ON#EE 107315 Commission No. EE107315 (Seal)
:y•.• ,r��: PIRES:AUG.25,2015
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Revised 07/15/2014
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