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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: \ 5I Q'— Cw�too
•
RECEP.'^D DEC 012015
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
s�i/ies
POS IMPROVEMENT LQCATION
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Address: 9156 PUMPKIN RIDGE RD-PORT ST LUCIE, FL 34986
Legal Description: MAIDSTONE(PB 43-11) LOT 14 (OR 228102511
Property Tax ID#: 3322-505-0023-0005 Lot No.
Site Plan Name: Block No.
Project Name: JONES
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION'
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REPLACE 1 SLIDING GLASS DOOR AND 13 WINDOWS WITH IMPACT.
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CCNSTRUCTI N>INFORMATION �' , %r451yr/,
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Additional work to be nertormed un er t is permit—check all h appy: .�.�.
HVAC Gas Tank Gas Piping _Shutters Z Windows Doors
11 ❑ ❑
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 19,711.09 Utilities:Sewer Septic Building Height:
,ODUNER/,LESS„ %i� ,// /a , // C ,NTRACTCR / eyyv r
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Q_uee""r.,F�i.. Bruce M Tyrrell,Jr
Name�,u����^� � Name: Y
Address:2 t� E 9 15�U(Imek..n �impany: Kamrell Windows&Doors
City: SI RT `"S L State:FL Address: 2441 SE Golfwood Drive
Zip Code: 3N GS 6Fax.772-288-6208 City: Stuart -FLStateF
Phone No.772-288-6205 Zip Code: 34996 Fax: 772-288-6208
E-Mail:PATI.KELVASA@KAMRELL.COM Phone No. 772-288-6205
Fill in fee simple Title Holder on next page(if different E-Mail: pati.kelvasa@kamrell.com
from the Owner listed above) State or County License: CGC061180
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Sl3PPLEMENT'AL CONSTRUCTlQN LIEN LAW INFORMATION '
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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 Counter 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 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.
_Signature of Owner/L ee/Agen Signature of Contractor/Lic se Ho r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MARTIN COUNTY OF Martin
The forgoing instrument was acknowledged re me The forgoing instrument was acknowledged before me
this 3D day of_ �N►b�20 &Ibt this 30 day ofd0JjQAMNc 20 IS by
BRUCE M TYRRLJLL,JR. Bruce M Tyrrell,Jr.
(Na au I a knowledging) (Name of per n acknowledging)
Ignature of Notary Ic-State of Florida) ignature of Notary Ic-State of Florida)
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
#FF085476 v mmission No. #FF085476 00 � Public State of Florida
Commission No. s �� t�bt®�Ipublic State of Florida :° Pa`tCia A Kelvasa
Patricia A Kelvasa ,'yc : My Commission FF 85476
My Commission FF 85476 Ex fres ot/
OF i� Expires 0172;77L,01 a w
Revised 07/15/2014
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