HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J ICY-
Date: ` / Permit Number: i/ IC7 " Q;��
RECEFVED
Building Permit Application /gyp
Planning and Development Services APR 2016
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
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Address: 9009 S Indian River Dr
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Legal Description: R A Saegers S/D M 135 FT of S 150 FT of LOT 1
Property Tax ID#: 3519-505-0002-000-6 Lot No.
Site Plan Name: Block No.
Project Na i e:
Setbacks Front Back: Right Side: Left Side:
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Replace (7) windows with impact-rated windows
Crj� RUCTQN INFQRMATIQN;,' �._ Aq.t^Man
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Monal work to be nertormed under this permit—check all appy:
[1HVAC Gas Tank Etas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 10,194 Utilities:-Sewer Septic Building Height:
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R/1. ��f' �� �CONTRATC)iR � �� a�
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Name Karen Hansiosten Name: Michael ODonnell
Address:28 Duffett Rd Company: ODonnell Impact Windows
City: Framingham State:MA Address: 6402 SE Federal Hwy
Zip Code: 01702 Fax: City: Stuart State.FL
Phone No.508-215-9673 Zip Code: 34997 Fax:
E-Mail: Phone No. 772-408-0200
Fill in fee'imple Title Holder on next page(if different E-Mail: rcodonnel1311 @gmail.com
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I State: City: State:
Zip: I Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: I Address:
City: I City:
Zip: I Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County y makes no representation that is granting a permit will authorize thepermit holder to build the subject structure
which is in cbnflict 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 stiructures,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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_Sig6ature of Owner/Lessee/Agent nature of Contractor/License Holder
STATE OFI FLORIDA STATE OF FLORIDA
COUNTY OF �a r�jo COUNTY OFA(&u-b n
The forgoi Ig instrument was acknowledged before me The forgoing instrument was acknowledged before me
this .i L# day of n rt � 20 J by this�day of 20 f�by
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A-[)/) ��vie_/l Ili j (,h a ell i)u. n ell_
(Name of person acknowledging) (Name of person acknowledging)--�
(Signaturelof otary u lic-State of Florida) (Signature of Not ryu lic-State of Florida)
Persona nown AOR Produced Identification Personally Known �O11 Produced Identification
Type of Idehtificatio P o c Type of Identification Produced
+1111111,,, , F�Au
Commissio No. .�`°'RYp° ` AMY WlRNER Commission No. ,.tr '�•.,, A Zw NER
_ Notary State of Florida Notary Pu a ate of Florida
-'« +•_ Commission #FF 962904 g ' Commission # FF 962904
Ay Expires M21 11 20 Al
Bonded through National Notary Assn. °FF`o?r`
ReV1SeC�07/15/20 '•+++++++•' Bonded through National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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