HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED F;OR APPLICATION TO BE ACCEPTED
Date: ��1 `I \ ---- Permit Number: (P -
i
RECEIVED-
Building Permit Application
Planning and Development Seivices SEP 2 9 2015
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce R 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: )�I�n U8,
PROPOSED,I IVLaPROVEM ENT=.LOCATION
Address: 775 SE Airoso Blvd,Port Saint Lucie,FL 34983
Legal Description: RIVER PARK-UNIT 6-BLK 58 LOT 8
Property Tax ID#:3419-545-0046-000-3 Lot No.8
Site Plan Name: Block No.
Project Name:Leroy or Sandra Macdonald
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRfIPTION 'F WORK.
Replacement of 10 windows
CONSTRU CTIO'N A N FO RMATION. .
itiona wor to a er orme under tis permit—c eca apply:
❑HVAC Ei Gas Tank Gas Piping _Shutters Windows Doors
❑ pg � /
Electric ❑_Plumbing Sprinklers 11 Generator EIRoof
Total Sq.Ft of Construction: S .Ft.of First Floor: !
Cost of Construction:$ 15496.00 Utilities:11Sewer Septic Building Height:
-OWN ER/LESSEE CONTRACTOR.' F
Name_Leroy or Sandra Macdonald Name:Alphonse P.Cam anelli
tl
Address: 775 SE Airoso Blvd Company:Storm Tight Windows,Inc.
City: Port Saint Lucie State: FL Address:1918 Corporate Drive
Zip Code: 34983 Fax: City:Boynton Beach State:Fl
Phone No. 772-878-5561 Zip Code: 33426 Fax..561-292-3562
E-Mail: Phone No. 561-536-4387
Fill in fee simple Title Holder on next page(if different E-Mail: stormtightpermits anoutlook.com
from the Owner listed above) State or County License:CRC046091.
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL`CONSTRUCTIQN LIEN LAVti/ INFORMATION:: s
S 1 K'
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 certifythat 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 thepermit 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 accessoryuses 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
commencing work or recording our Notice of Commencement.
0APLAP , rr,101491�9m&_
Signature pf Own J,Agent/Lessee . Signatur of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S+ LlOf COUNTY OF PUM I3ead,%
The fo�oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
I
this &day of5Pnhe�ber 20 1&by this�day of Sf.��- re h?T .zoJS by
&VAM T Int O nnnald onse Coy h
(Name of person acknowledging) {Na a of person ackn wledging}
'(Signature of 146tary Public-State of Florida} T signatureof�ublic-State of Florida}
Personally Known ✓ OR Produced k,9cn0SjW _ Personally Known ✓ OR Produced Identification
1.Lea Murrell
Type of Identification Produced,caSv�f �4L� Type of Identification Produced
aqT OF FLORIDA �ARY PUBLIC
Commission No.i"F17'(o!�( TE C ah Commission No. rf' QAT
v, o�m#FF177686 E OF FLORIDA
1')i Expires 11/18/2018 Comm#FF177686
�dCE 1S e -xplreS IWzuI
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS