HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater 5` 15 Permit Number: S 4l -a a 4 s
RECEI`"D SEP 151015
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 FORS
PROPOSED I N OR'OVEM ENT-LOCATION
Address: 1504 N 39th Street,Fort Pierce,FL 34947
Legal Description: SUNLAND GARDENS BLK23 LOT 1 AND WLY 1/2 OF LOT 2
Property Tax ID#:2405-601-0411-000-8 Lot No.1/2
Site Plan Name: Block No.23
Project Name:Vivian P Ellis
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION,'OF WORK:`'
Replacement of-I.L4 windows
'CONSTRUCTION.INFORMATION
Additional wor toa nertormed un er t is permit—checK all t=apply:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑Plumbing Sprinklers ElGenerator E]Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 30474.00 Utilities:11Sewer OSeptic Building Height:
OWNER/LESSEE: :CONTRACTOR: ;.
Name Vivian PEllis Name: AIpiioi1(? C°AmponekU
Address: 1504 N 39th Street Company:Storm Tight Windows,Inc.
City: Fort Pierce State: FL Address:1918 Corporate Drive
Zip Code: 34947 Fax: City:Boynton Beach Stater
Phone No. 772-577-0722 Zip Code: 33426 Fax:561-292-3562
E-Mail: Phone No. 5W1 "53�v'— 381
Fill in fee simple Title Holder on next page(if different E-Mall:(;trf'Yl* hfRU1X1i'_.e�?�L( °ie_ c,om
from the Owner listed above) State or County License: C:IZI%�4lsaC3�l 1
If value of construction Is$2500 or more,a RECORDED Notice of Commencement Is required.
_ia
SUPPLEMENTAL.CONSTRUCTION LIE-NrLAW INFORMATION,: 4
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 priorto the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holderto build the subject structure
which is in oon list 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
commeRcing work or recording our Notice of Commencement.
Signa vreb. Owner/Agent/�Lesse Signature of Contractor/License Holder
�w.
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFFa p m rAectck,, COUNTY OFFc,_ly►1
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of iJI i/L� 20 A-5 by this day of (�e_p+rwbe r -20_E by
\!arra an E t I S /?rl R hoigSp ('-C(-.Vn paine w
{Name of person acknowledging) {Name of person acknowledging}
(Signature of Motary Public-State of Florida} {Signature of Nbl�blic-State of Florida}
Personal) Known e3 g ✓ OR Produced Identification
Personally ✓ OF�� � �,��'�Id�'�"1s��on Personally Known
Type of Identification Produ ,q NOT "urrT i Type of Identification Produced ,ots�4v,,
Sy'Are LIC a( on flfQT a ��ufiell
Commission No.EPI S�u`�'8c+ t9'�fl°� � OFFLQRIDA Commission No. F 1Zi�as � A Y1'VBLIC
E-Wres 17/1gB86 s�� 1910 QC ®F FLQRIQA
�AP'res 11/18/2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS