HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ' �_�<n Permit Number: �0 U��' �fJ 0
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RECGIV�®
Building Permit Application 14AR Z,8 2016
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential_X _
PERMIT APPLICATION FOR:tk;�ry_\(xZ,,S
PROPOSED IMPROVEMENT LOCATION:
Address: 601 Bartow St,Fort Pierce,FL 34982
Legal Description:INDIAN RIVER ESTATES-UNIT 06-BLK 12 W 1/2 OF LOTS 23 &24
Property Tax ID#:3402-607-0049-000-1 Lot No.23&24
Site Plan Name: Block No.12
Project Name:Allan&Diane Colby
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacement Windows(5)
CONSTRUCTION INFORMATION:
itiona wor, to e r orme under tis perms —check all apply:
OHVAC Gas Tank ❑Gas Piping in Shutters Windows Doors
11 Electric ❑Plumbing ❑ _Sprinklers Generator Roof
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 5,200.00 Utllitles:11Sewer ElSeptic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Allan&Diane Colby Name:Sam Ochstein
Address: 601 Bartow St Company:Newsouth Window Solutions
City: Fort Pierce State: FL Address:2526 Okeechobee Blvd.
Zip Code: 34982 Fax: City:West Palm Beach State:FL
Phone No. 772-579-1259 Zip Code: 33409 Fax:561-478-4100
E-Mail: Phone No. 561-712-9000
Fill in fee simple Title Halder on next page( if different E-Mail:westpalmbeach(a,newsouthwindow.com
from the Owner listed above) State or County License:CRC1330822
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: 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 Countv makes no representation that Is granting aAermit will authorize the permit holder to build the subject structure
which 1s In conflict with any applicable Home Owners Associatlon 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
commen
cing work or recordingour Notice of Commencement.
C��- h rJ69•
Signature of Owner/Agent/LesseU Signature of Contracto/License Holder
STATE OF FLORID STATE OF FL I�pA
COUNTY OF c{P41,�. �axi& COUNTY OF, ,\rr� r�CSI
The forgoing instrument was acknowledged before me TheorgoIng instrument was acknowledged before me
this?-( day of 0D_Q f_n 20 V by this `"'ll day ofMCk_'fQC_\ 20�by
ALLA
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{Name of person acknowledging) {Name of person acknowledging)
{Signature of Notary Public-State of Florida} (Signature of tar Public-State of Florida}
Personally.Known OR Produced Identification )G Personally Known OR Produced Identification
Type of Identification Produced I Type of Identification Produced
Commission No. Commission No.
KIM A.STONE KIM A. STONE
F923u• MY COMMISSION#FF929006
pJCP .Octaba 15.20 f` ober 15,2019
Revised 07/15/2014 or
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