HomeMy WebLinkAboutBuilding Permit Application I�
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: X --An' )�C Permit Number: �®
R
AUG 2 6 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
PERMIT APPLICATION FOR: Window/door
PROPOSED IIVII?RQVEMENT LOCATION
Address: 4249 S Indian River Drive
Legal Description: 35 35 40 N 100 FT OF SE 1/4 OF NE 1/4 AS IN DBK 89-323 (16) (OR 1350-319; 1901-237;
2515-2927; 3175-1903)
Property Tax ID#: 2435-141-0002-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Mattson
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK r
Replace one door, 14 windo with impact),and 7 mullions size for size.
CONSTRUCTION INFORM "' O_N
Additional work toe e orme under this permit—check a appy:
OHVAC E] Gas Tank ❑Gas Piping _Shutters 21 Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$�1 0 , QI ff n . n Utilities:DSewer Septic Building Height:
01NNER%LESSEE CON TR°ACTOR. ,
NameBrenda Mattson Name: Mark Collins
Address:4249 S Indian River Drive Company: Window World of West Palm Beach
City: Ft Pierce State:FL Address: 1500 N Florida Mango Rd Ste 16B
Zip Code: 34982 Fax: City: West Palm Beach State:FL
Phone No.772-971-1538 Zip Code: 33409 Fax: 561-684-2050
E-Mail: Phone No. 561-684-2040
Fill in fee simple Title Holder on next page(if different E-Mail: westpalmbeach@windowworld.com
from the Owner listed above) State or County License: CBC1260052
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 OW ER:Your failure to Record a Notice of Commencement m esult in your twice for
improvement ur pro rt �intejto
of Commencement must eco ed an sted on t e jobsite
before the '� pecti ouo obtain financing, con wi ende an attorney efore
comme.i ork o rdince of Commenceme
/ s
/ nature of Owner Lessee Agent ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST Lucie COUNTY OF ST Lucie
The fqrgoQ�ing insti- ent was ac nowledged afire me The forg ing instru ent was acknowledgedb ffe me
this 20 of 20 �by thisay of F� 20 �Jby
Mark Collins
(Name of person acknowledging) (Name of person acknowledging)
(Signature 6f Notary Public-State of Florida) (Signature - otary Public-State of Florida)
Personally Know OR Produced Identification Personally Known X OR Produced Identification
Type of Identification P Type of Identification Produced
'"","'� AB� AI� JOHNSON
ABIGAIL JOHNSON
Commission No. _ = Notaryl)c. State of Florida Commission No. °'' Notar
y E ,State of Florida
My comm.expires May 19, 2019 =+,'•••..��r�� My comm, expires May 19, 2019
Revised 07/15/2014
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