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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �a �� �5 Permit Number: 151 a^aa� y
' -�- RECEI'."70 DEC 16 2015
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 FOR•-�vr�u«�11vl- %Z \
-PRi7ROSED hIVI PROVEM ENT.LOCATION: q
Address: 10101 Bluefield Road Okechobee FL 3A C.1 /
Legal Description:4/09 37 37 FROM SE COR SEC 4 RUNW ON SEC LI 1512 FT TO C/L BLUEFIELD RD,TH N 30 DEG 34 MIN 05 SEC W
1
Property Tax ID#:4104-344-0040-000-0 Lot No.
Site Plan Name: I Block No.
Project Name:Sandra F Silasavage
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacement of 12 windows
CO
NSTRUCTIt7N.INFORMATION
Additional work to be er orme under tis Permit—c ec a appy:
❑HVAC Ei GaS Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator E Roof
Total Sq.Ft of Construction: S .Ft:of First Floor:
Cost of Construction:$ 20430.00 Utilities:Sewer Septic Building Height:
wN ER/LESSEE CONTRACTOR:'.
Name Sandra F Silasavage Name:Alphonse P.Campanelli
Address: 10101 Bluefield Road Company:Storm Tight Windows,Inc.
City: Okechobee State: FL Address:1918 Corporate Drive
Zip Code: ? Fax: City:Boynton Beach State:Fl
Phone No. 863-763-1627 Zip Code: 33426 Fax:561-292-3562
E-Mail: Phone No. 561-536-4387
Fill in fee simple Title Holder on next page rj if different E-Mail:stormtightpermits(aoutlook.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.
0
SUPPLEMENTAL CONSTRUCTION 1IEN'LAW INFORMATIM,
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 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, I
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_O.wner/_Agent/_Lessee_. Signatu a of Contractor License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ¢=',,71vr„ ge ocl. COUNTY OF Q
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me I
this—,9 dayof/Jeced,_1 ,e,, 20-M by this Jam_dayofOece,..,6e, ,201jrby
�S'aho/•-a cS'i/osavagc' �9��os-lse C�:v.,oas-.eL/i
(Name of person acknowledging) {Name of person acknowledgingol
}
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(Signature of Kotary Public-State of Florida} (Signature of 46tary Public-State of Florida}
Personally Known OR Produced Identification Personally Known -_ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.?f/77Lef1 co ��,
}�yOT aLevrerr Commission No. � � °�a��
z' - , S' rE YpUeC/C 910 --n .�'�`STgT RYF'UsUI"e!/
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