HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:T�� Permit Number:
' = RECEI� ^D APR 06216
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
PROPOSED IMPROVEMENT LOCATION:
Address: 5603 MYRTLE DR. FORT PIERCE FL.34982
Legal Description: INDIAN RIVER ESTATES-UNIT 8- BLK-54-LOTS 37 AND 38 (MAP 34/11 N
Property Tax ID#: 3402-609-0095-0004 Lot No.37 & 38
Site Plan Name: Block No. 54
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REPLACE 11 WINDOWS 1 SLIDING GLASS DOOR AND ALUMINUM STORM PANELS FOR
11 WINDOWS AND 1 SLIDING GLASS DOOR
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping Shutters a Windows/Doors
Electric ❑ Plumbing EJ Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$_(,'701 `� Utilities:Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name RICKEY WORKMAN Name: MATTHEW MARKS
Address:5603 MYRTLE DR Company: EAST COAST ALUMINUM PRODUCTS
City: FORT PIERCE State:FL Address: 913 EDWARDS RD
Zip Code: 34982 Fax: City: FORT PIERCE State:FL
Phone No.772-216-6871 Zip Code: 34982 Fax: 772-464-7603
E-Mail: Phone No. 772-464-7600
Fill in fee simple Title Holder on next page(if different E-Mail: ECAPINC@HOTMAIL.COM
from the Owner listed above) State or County License: 24526
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 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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.
K �� S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S7- LRCIF- COUNTY OF r7,U__tr
The forging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this G day of AfQ IL 201 L by this Lf` day of Anti L '20 L_by
MAT714>kw MAtekr M#JA rTAew Ai Ae-"
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-'State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known c� OR Produced Identification
Type of Identification Prod c Type of Identification Produced
DONALD M.HOLMAN
,`i� , "a�P ONALD M.HOLMAN
Commission No. ,ter° `�; f(1St )Publlc-State of Ftorld ommission No. ,.P oa��,,, (Seaf�
C 91lZyo Commlaslon#FF 913240 j'r QI 1ZYa __+ «�s Notary Public-State of Florid
,7 Commission#FF 913240
My Comm Filpires SOP 20 2 Banded through National Notary Assn.
Bonded through National Notary Ass
Revised 07/15/2014
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