HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: y Permit Number:
- RECEI1.'70 APR 19 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34382
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:_Shutter, t"' "��►a�
PROPOSED IMPROVEMENT LOCATION:
Address: 102 CARLISLE LN,PORT ST.LUCIE,FL 34952
Legal Description: 16 36 40 s 125 ft of se 1/4 lyg a of st lucie riv-less a 30 ft ford rd r/w
Property Tax ID#:3416-444-0002-000-4 Lot No.
Site Plan Name: Block No.
Project Name:PARKS,IRENE AND RICHARD
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replacement Windows(8)��fy Ci
CONSTRUCTION-INFORMATION:
t ona wor to a er orme under this permit—checK all that apply:
OHVAC 0Gas Tank Gas Piping _Shutters ®Windows/Doors
DElectric ❑Plumbing Sprinklers ❑Generator Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 11,842.00 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name PARKS,IRENE AND RICHARD Name:Sam Ochstein
Address: 102 CARLISLE LN Company:Newsouth Window Solutions
City: PORT ST.LUCIE State: FL Address:2526 Okeechobee Blvd.
Zip Code: 34952 Fax: City:West Palm Beach State:FL
Phone No.!Q- Q Z.. Zip Code: 33409 Fax:561-478-4100
E-Mail: Phone No. 561-712-9000
Fill in fee simple Title Holder on next page( if different E-Mail:westpalmbeachnanewsouthwindow.com
from the Owner listed above) State or County License:CRC 1330822
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN`LAW INFORMATION
DESIGN ER/EN GINEER: _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 Hermit 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 wcirk or recocojffjour Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLQVDA
COUNTY OF_)r V�[X , COUNTY OF VC)Qnl beciC.ln
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this%S day of A 20 4 by this J�j:_day of nL-R a ,20j(pby
1SCL h,
{Name of person acknowledging) {Name of person acknowledging}
Si ure of Notary Public-State of Florida I(Sig4Ude of Notary Public-State of Florida}
Personally Known ORP dgc1entfication Personally Known OR Produced Identlflcatlon
Type of Identification Produced of Identification Produced
41 KIM Ter
Commission No. 012�ao�PMI
ION
y� ssRME :October lION N s. mission.No. "`�, A. gTONE
MY COMM1S510N#FF9280p6 ;
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS