HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
x Building Permit Application
Planning and Development Services
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: Shutter
PROPOSED INIPROVEMENT:LOCATION
a
Address:19i4-S Indian River Dr Unit 1002,Jensen Beach,FL 34957
Legal Description:INDIAN RIVER LANDING BLDG 10 UNIT 1002 AND UNDIV SHARE IN COMMON ELEMENTS
Property Tax ID#:4509-804-0063-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Cheryl Ann Marciano
Setbacks Front Back: RightSide: Left Side:
DETAILED DESCRIPTION OF WORK
Replacement of 1 windows 1 doors
CQN5TRUCTION INFORMATION
itiona wor to a er orme under tis permit—c ec a appy:
OHVAC 11 Gas Tank ❑Gas Piping _Shutters Windows/Doors
❑Electric ❑Plumbing ❑Sprinklers ❑Generator ❑Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 10895.00 Utilities:]Sewer❑Septic Building Height:
O1NN ER/,LESSEE CONTRACTOR:
9
Name Cheryl Ann Marciano Name:Alphonse P.Campanelli
Address: 13251 S Indian River Dr Unit 1002 Company:Storm Tight Windows,Inc.
City: Jensen Beach State: FL Address:1918 Corporate Drive
Zip Code: 34957 Fax: City:Boynton Beach State:F1
Phone No. 772-497-4964 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:stormtightpermitsnaoutlook.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 GONSTRUGTIO,N;LIEN LAIN INFi7RMATION.' :
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 priortothe 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
i pure . w"erJ Ag J Lessee_ Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SV- Gu a'e COUNTY OF e—k
Thefo oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of AJe Pvs-ber 20 irby this-0 day of A1.o P a ou 6e.*- .20 my
I",A er c// M'PL a b,.o ! "Oe H a'k1.e/h
(Name of p rson acknowledging) (Name of person acknowledg' g)
(Signature of NdWy Public-State of Florida) Signature of Nbt6ry Public-State of Florida}
Personally Known :/ OR Produced Identification Personally Known ./ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Vc aria Lee Murrell ft�lft
Vi toria Lee Murrell
Commission No. �/ lob °t Y Commission No.���77!! vARYPUBLIC
ARY PUBLIC o I c STATE OF FLORIDA STATE OF FLO RIDA
°r77686
Expires 11/18/2018 o ® 77686o
Revised 07/15/2014 Cf 19► Expires 11 $
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4127855 OR BOOK 3804 PAGE 1253, Recorded 11/03/2015 at 10:05
AFTER RECORDING-RETURN TO: 1 -
PEKMIT NUMBER: L This Spore is reserved for recording Info
NOTICE OF COMMENCEMENT J
The undersigned hereby given notice that improvement will be mode to certain real properly,and in accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commencement.
1.DESCRIPTION OF PROPERTY(Legal description and street address)TAX FOLIO NUMBER:4509-804-0063-000-1
SUBDIVISION -BLOCK-TRACT-LOT-BLDG-UNIT
INDIAN RIVER LANDING BLDG 10 UNIT 1002 AND UNDIV SHARE IN COMMON ELEMENTS
2.GENERAL DESCRIPTION OF IMPROVEMENT:Replacement Of 1 windows I doors
3.OWNER INFORMATION: a.Name Cheryl Ann Marciano
b.Address 13251 S Indian River Dr Unit 1002,Jensen Beach,FL 34957 c.interest in property
J� d Name and address of fee simple titleholder(if other than owner)
4.CONTRACTOR'S NAME,ADDRESS AND PHONE NUMBER: Storm TilZht Windows,Inc.
1918 Corporate Drive,Boynton Reach Fl 33426 Phone:561-536-4387
5.SURETY'S NAME,ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6.LENDER'S NAME,ADDRESS AND PHONE NUMBER:
7.Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.-13(1)(a)7.,Florida Statutes:
NAME,ADDRESS AND PHONE NUMBER:
8.In addition to himself or herself,Owner designates the following to receive a copy of the Lienor s Notice as provided in Section
713.13(l)(b),Florida Statutes:
NAME,ADDRESS AND PHONE NUMBER:
9.Expiration date of notice of commencement(the expiration date is 1 year from the(Lite ofrecording unless a dillerent date is
specified) 20_
WARNING TO OWNER:ANY PAYMENT'S MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT
ARE CONSIDERED INIPROPER PAYMENTS LINDER CHAPTER 713.PART I SECTION 713.13.FLORIDA STATUTES,AND CAN RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POST' ON THE JOB SITE BEFORE THE FIRST INSPECTION IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH YOUR
L' ER RAN ATTORNEY BEFORE COMMENCING WORK OR RECORDING.YOUR NOTICE OF COMMENCEMENT.
.. .. ._rt�'tor/Parhrci/jNiia.9gcr �
State of Florida
county of St.Lucie
The foregoing instrument was acknowledged before me thisnay of_A/tl fYmmdr� 20 /S
By (',Iles-(// 1t fdhrn1;A' o as_ d6t/llrr
(Printed nat a of person signing above) (Type of authority...e.g.Owner,officer,trustee,attorney in fact)
For eft
(Name of party on behalf of whom instrument was executed) Personally Known or produced the following type of ID:
r Victoria Leo Murrell
NOTARY PUBLIC
//i C/Ori a Lep /t(u ii-r LI ini�. _ a STATE OF FLORIDA
c a Comrntt FF177686
(Printed Name of Notary Public) (Stgnaurre of ary Public) (Scan
�hcE 1470 Expires 11/18/2018
Under penalties of pcdury,1 declare that I have read the foregoing and that the facts in it are We to the best of my knowledge and
belief(section 92.525,Florida Statutes).
, 1$?;r+e3? .' thOriz0tl 011Icer/DltgctprrRtipeNMeragerwbo rlgnod aboyp:
I 12i /�'/stRf/AA�D
.,.. ted Name
STATE OF FLORIDA
ST.LUCIE COUNTY
THI IS CERTIFY TH T T SIS
TRUE CORRECT C PY F T E
ORIGI
PH ITH, LE K
P
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erk '
Date