HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1142 Permit Number: 1 ('02; q 93
RECOVE
Building Permit Application FEB 2 9 201
Planning and Development Services
Building and Code Regulation Division Lucie County, FL
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2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucnty
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED i,MPROVEMENT L'O.CATION ;
Address: 4001 MILLISA TER, FT PIERCE 34947
Legal Description: NARTMAN HEIGHTS UNIT 1 LOT1 4001 MILLISA TER
Property Tax ID#: 241760200010001 Lot No.1
Site Plan Name: Block No. 1
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF W'O'RK
INSTALL STORM PANELS ON THREE WINDOW OPENINGS AT THE MASTER BEDROOM
WING, ONE DIRECT MOUNT, TWO WITH HEADER & BOTTOM TRACKS
CONSTRUCTION-LNFORMATION
Additional work to be nertormed under this permit—check all thA appy:
11_HVAC Gas Tank []Gas Piping Shutters .❑Windows/Doors
Electric ❑Plumbing []Sprinklers ElGeherator - Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 475.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE._ CONTRACTOR:
Name MELODY BLY Name: CLIFFORD WELLS
Address:4001 MILLISA TER Company: TREASURE COAST HOME IMPROVEMENTS, INC
City: FT PIERCE State:FL Address: 873 SW CALIFORNIA BLVD
Zip Code: 34947 Fax: City: PORT ST LUCIE State:FL
Phone No.772-971-7516 Zip Code: 34953 Fax: 772-673-3783
E-Mail: Phone No. 772-263-9287
Fill in fee simple Title Holder on next page(if different E-Mail: CLIFFW5050@GMAIL.COM
from the Owner listed above) State or County License: CR C_o'S'19 O
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU PPLEMENTAL"CONSTRUCTION oEN�,tAW INF,, RMATIQI °i
DESIGN ER/ENGINE.ER:, ,.. ..
x 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: X 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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_Sign re of wner/Lessee/Agent Signature of ntr ctor/License Holder
STATE OF FLORIDA STATE OF LORIDA
COUNTY OF �)(',►[, COUNTY OF
The forgoing instr e'llt was acknowledged before me The forgoing instru was acknowledged before me
this day of 201-6-by this day of 20 Llv by
V-0 I L► EGd Wel k
(Name of perso cknowledging) (Name of person acknowledging)
I I AA �A -1 1AA
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(Signature of No aryPublic-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced [l•L: Type of Identification Produced
Tom'
Commission No. l9n •",5'p4WtN S. NIELSENommission No. (Seal)
Commission# FF 115637
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M Commission Expi °�aYaU'% KAREN S. NIELSEN res coo` B,a,
June 125 2018 ;. t_ mmissionfF FF 11563
s; °,�° My Commission Expires
Revised 07/15/2014 ''�.e°F'�°"� June 12, 2018
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