HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '"1` 1 � \S Permit Number: \5 0` -00 ola
SEP 011015
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 IMPROVEMENT LOCATION:
Address: 108 Rio Mar
Legal Description: River Park Unit 10 Block 83 Lot 8(Map 34/22S )(OR 1701-2610;3098-2719)
Property Tax ID#: 3419-575-0009-000-5 Lot No.8
Site Plan Name: Block No. 83
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and Replace ( 3 ) windows
CONSTRUCTION-INFORMATION:
ACICIrtionalworktotienerformed under this permit—checK all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers [Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 1,890.00 Utilities-In Septic Building Height:
OWN ERAESS'EE: CONTRACTOR:
Name Betty Sparling Name: Brown Johnson Jr.
Address:125 S. State Rd 7 Ste 104-228 Company: JBR Exteriors, Inc
City: Wellington State:FL Address: 1201 SW Biltmore St.
Zip Code: 33414 Fax: City: Port Saint Lucie State.FL
Phone No. Zip Code: 34983 Fax: 772-871-6377
E-Mail: Phone No. 772-873-0600
Fill in fee simple Title Holder on next page(if different E-Mail: info@jbrexteriors.com
from the Owner listed above) State or County License: 17922
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
.SUPPLEMENTAL CONSTRUCTION-,LIEN LAW INFORMATION?f
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 OWNS • our failure to Record a Notice of Commencement may result in your paying twice for
improvemen rn
yfe
r p�ILyou
. A Notice of Commencement mus a recorded and posted on the jobsite
before the f' stscho intend to obtain financing, co ultr or an attorney before
commenci wk reour Notice of Commencemen .
s
_Signature of Owner/Lessee/Agent Signature of ntractor/License Holder
STATE OF FLO IDA STATE OF FLORIDA
COUNTY OF Vb CT / LAr -t? COUNTY OF S 1 (.,,(A.Cir -�
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this day of ,TU (�' 20 L—by this �� day of A u ,20 by
(Nam �f person ackno edging) (Name f person acknowledging)
P,
(Si a of Notar e&ublicc- of Florida) (Si ot&r ublic-St to of Florida)
erson y Known f// r ti is 'o ersonall own tification
Type of Identificationo T.—Nuta.y Public 3S[tileype of Identification Prod e
ilyr-uIns tate of Fimida
.4F_ Af. Joshua Shane Alberico Joshua S ne Alberico
Commission No. My Cornf&866h EE 827424 Commission No. n EY On EE 827424
ago Expires 08/16/2016 xpKes 0816/2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS