HomeMy WebLinkAboutBuilding Permit Application ALL I
APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _ '1 1 t(6 Permit Number: ICu(3 - a
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RECEI%";D APR 0 8 2016
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: -shuttef
P) C?PQSER 11EPR01/EMENT
Address: 211 SE Camino St,Port Saint Lucie,F134952
Legal Description: RIVER PARK-UNIT 3-BLK 31 LOT 9
Property Tax ID#:3419-515-0276-000-1 Lot No.9
Site Plan Name: Block No.31
Project Name:Jusith Woerfel
Setbacks Front Back: Right Side: Left Side:
aE,TAIL.ED DESCRIPTION QF 1tC?klt. i
z :
Replacement ofl�,vindows (d doors
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1"'CONSTRUCTIClN INFORMATION
3
ACIClitional wor to De Derformea under tis,permit—check all appy ro
OHVAC Gas Tankfil
❑Gas Piping MGenerator
ShuttersWindows/Doors
Electric Plumbing Sprinklers r Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 24141.00 Utilities:11Sewer Septic Building Height:
OWNERfLE5SEE:R �f �O#7'1IAORrr }
Name Jusith Woerfel Name:Alphonse P. Campanelli
Address: 211 SE Camino St Company:Storm Tight Windows,Inc.
City. Port Saint Lucie State: Fl Address:500 SW 12th Ave
Zip Code: 34952 Fax: City:Deerfield Beach State:FL
Phone No. 772-878-8547 Zip Code: 33441 Fax:561-292-3562
E-Mail: Phone No: 561-536-4387
Fill in fee simple Title Holder on next page(if different E-Mail,:,stormtightpermits(&outlook.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.
SUPPLE MENTAL CC?NSTRUCTIQN LIEN LAUV INFC?ftIVIATIt�N:
a
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 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.
4o
atuc �6fQwn_erfAl1�e:rtt/ Signature of Contractor/License Holder
STATE OFSTATE P)�FL
COUNTY OF (.V \ COUNTOY OF ORS 1 rn a
The fo ing instr ent wa acknowledged Pefore me The foygaing instrwnent was acknowledged Pefore me
thisday of ' 20 IfAy this day of ,20y
YAP��4 ANGELA K.LIMPPO o�uemsu�uieAAal m41 PaP008 `,aow fid `
sed° Commission#EE 187663 Bl0l58CD08 �e sejtdx3
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a e of person acknowledgi Eypires uoiSSl =�. os
Bo���NTroyFzninsuran�eaoo-aesa�� ame of person acknowledgi g)£99L86 33# .,,V d.A .,.•
q�,„ Oddvin'�tf13JNd
(SiOa ure of Notary r
uVic-State of Florida} (Sig tre of Notary P b -State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. {Seal} Commission No. (Seal)
Revised 07/15/2014 /
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