HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: W) !
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 IIti PRMEME IT IN.
Address: 11124 LANDS END CHASE, PORT ST LUCIE FL 34986
Legal Description: RESERVE PLANTATION-PHASE IIA LOT 9(MAP 33/28N)(OR 3704-1336: 3774-2821)
Property Tax ID#: 3321-803-0015-000-8 Lot No.9
Site Plan Name: Block No.
Project Name: PATTI AMARO
Setbacks Front Back: Right Side: Left Side:
DETAILED DE :R1.0TI0N DF WORK:
l0stalf
i/M
Additional work toe e orme un er t is permit—check a appy:
HVAC 13 Gas Tank Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers FI Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 6807.00 Utilities:USewer aSeptic Building Height:
Name PATRICIA A.AMARO Name: SCOTT BERMAN
Address:11124 LANDS END CHASE Company: FLORIDA WINDOW AND DOOR
City: PORT ST LUCIE State:FL Address: 7108 FAIRWAY DR#120
Zip Code: 34986 Fax: City: PALM BEACH GARDENS State:FL
Phone No.772-242-1809 Zip Code: 33418 Fax: 561-624-8037
E-Mail: jr /Y1Q1 Phone No.
561-340-4300
Fill in fee simple Title Holder on next pag (if different E-Mail: HOWARD@FLORIDAWINDOWANDDOOR.COM
from the Owner listed above) State or County License: CGC1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
-
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: ✓ Not Applicable
Name: Name:
Address: Addcess:
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.
�_O A a ri I(L s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA /
COUNTY OF VC61AA (Ckl _ COUNTY OF J' (�_3�4
The forgpu�e
ing instrument was acknowledged before me The forgoing instr7it was acknowledged before me
this h` day of 11C z� , 20�by this J �
day of- e �( 201 _by
PATRICIA A.AM/IRO SCOTT BERMAN
(Name of person acknowledging) (Name of person acknowledging)
(Signature. f Notary Public-State of Florida 115rignature of Notafy Public-State of Floc'
Personally Known OR Produced Identification Personally KnownOR Produced Identification
Type of Identification Produced(X,L'iicrj1L ftg, I 5e1_ri`= Type of Identification Produced
Commission No. FPDX o 141 (Seal) Commission NoZee we (Seal)
o�
�Ru � HOWARD SIMKOFF
s-.+; ^* iviY CON1a"ISSiO J EE 830735
Revised 07/15/2014 •', My C40MMWION M FF961427 n'sr. � Bonded Thru Budget Wary Semces
E
,c EXPIRES Febmq 16,2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS