HomeMy WebLinkAboutBuilding Permit Application ALL APIPLIC INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: '0 (? S Permit Number:
• RECEI��C OCA 0 7101.
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: 7656 Green Brier Circle Port Saint Lucie, FI. 34986
Legal Description: Pod 19 Pud II Greenbrier(PB 41-5 Lot 46(OR 3236-1246)
Property Tax ID#: 3322-700-0051-000-9 Lot No.46
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE <<:.. .;
SCRIPTION,OF WORK:
Replace ( 1 ) Sliding Glass Door at rear of house
CONSTRUCTION INFORMATION:.
Additional work to be ertormed under this permit—check all appy:
HVAC Gas Tank E]Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers FIGenerator E]Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
2-3p5.
Cost of Construction:$ Utilities: Sewer Septic Building Height:
-OWNER/LESSEE CONTRACTOR:
Name John and Janet Trude Name: Brown Johnson Jr.
Address:160 Grand Cypress Lm Company: JBR Exteriors, INC
City: Blue Mountains State:ON Address: 1201 SW Biltmore ST
Zip Code: L9Y OK8 Fax: City: PSL 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:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: hone: 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 f' inspection. If you intend to obtain financing, c s t with lender or an attorney before
commendr r recordingour Notice of Commencem t.
s
—Signature of O es a/Agent Signatur ont or/License Holder
STATE OF FLORID STATE OF FLORID
COUNTY OF �T- L u C. t D COUNTY OF T Z_44 f p,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of O CT` 20 16—*by this-ko day of b GT" 20 1,1�* by
q ja t �70�UO-1 � (I� CAA
(Name of person acknowledging) (Name of person acknowledging)
1�2L� 2 ,22k:�
ign re of Notary Public-State of Florida) (Sign ur of Notary Public-State of Florida)
Personally Known_�OEExpires
tification Persona nown f� OR Produced Identification
Type of Identification Produc a of Identification Prod
ry Public tate of Florida 7AZk Notary Public State of Florida
h�uua Shane AlbeF Jos a ane Alberico
Commission No. Nmmission EE ez7a2a mmission No. My C�mrn�ission EE 827424
08/16/2016 9`�ov�°�� Exnlre508116/2078
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS