HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
rr..r
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: 9554 Avenel LN Port St Lucie, FL 34986
Legal Description: PINES AT THE RESERVE LOT 27 (OR 3826-2556)
Property Tax ID #: 3322-502-0033-000-9 Lot No.
Site Plan Name: Block No.
Project Name: POLO
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
[CONSTRUCTION INFORMATION:
itiona workto (eer orme un er this permit - check a appy:
a
11 HVAC L! Gas Tank 7Gas Piping _ Shutters Windows/Doors
❑ Electric ❑ Plumbing Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ -D )l -�� Utilities: _ Sewer � Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
1 C
Name
Name: Bruce M Tyrrell, Jr
Company: Kamrell Windows & Doors
Address: QS��)rt�r,� =v��� _
Address: 2441 SE Golfwood Drive
City: (L' State: F(-.
City: Stuart State: FL
Zip Code: 3 `i cC W _ Fax:
Phone No. �I 1 - �� 3
Zip Code: 34996 Fax: 772-288-6208
E-Mail:
Phone No. 772-288-6205
Fill in fee simple Title Holder on next page ( if different
E-Mail: pati.kelvasa@kamrell.com
State or County License: CGC061180
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
_
Address:___
Address:
City: State:
Zip: Phone:
i
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 thepermit 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
commenciniz work or recording vour Notice of Commencement.
< 7
_ Signature of Owner/ L ee/Agent Signature of Contractor/Licen,,96 Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF MARTIN COUNTY OF Man,,
The forgoing instrument was acknowledged before me
this __L day of ` 20 ( bby
BRUCE M TYRRELL. JR.
(Name of pp son acknowledging )
ature of Notary P Ic- State of Florida )
Personally Known x _ OR Produced Identification
Type of Identification Produced
Commission No. #FF085476
Revised 07/15/2014
PATRICIA A. KELVASA
(10r130MMISSION #tFF085476
EXPIRES: JAN 22, 2018
The forgoing instrument was acknowledged before me
this Il, day of 20 1 by
r
Bruce M Tyrrell. Jr
(Name of person acknowledging )
Ignature of Notary P - State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produce
Commission No. #FF085476 ?°`` � M�rISSION#tFF085476
EXPIRES: JAN 22, 2018
Bonded through 1st State Insurance
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS