HomeMy WebLinkAboutcorrected front page of applicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and Development Services
Building and Cade 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
Address: 12458 Harbour Ridge BLVD Palm City, FL 34990
Legal Description: RIVERSIDE VILLAGE UNIT 2-5 AND UNDPRO-RATA SHARE IN COMMON ELEMENTS (OR 3747
Property Tax ID #: 4426-510-0013-000-0
Site Plan Name:
Project Name: cooney
Setbacks Front Back:
Install one entry door with impact
HVAC LJ Gas Tank
Electric ❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2,900.00
Name Patrick Cooney
Address: 12458 Harbour Ridge Blvd
Right Side:
Piping
Sprinklers
Left Side:
apply:
_ Shutters
❑ Generator
S Ft. of First Floor: _
Utilities :❑ Sewer ❑ Septic
City: Palm City State: FL
Zip Code: 34990 Fax:
Phone No.
E -Mail: pjcooney@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Bruce M Tyrrell, Jr
Lot No.
Block No.
ZWindows/Doors
❑ Roof
Building Height:
Company: Kamrell Windows & Doors
Address: 2441 SE Golfwood Drive
City: Stuart State: FL
Zip Code: 34996 Fax: 772-288-6208
Phone No. 772-288-6205
E -Mail: pati.kelvasa@kamrell.com
State or County License: CGCO61180
value of construction is $2500 or more, a RECORDED Notice of Commencement is
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_ Not Applicable
_Not Applicable
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 applicationsare 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.
.� /� '-'v ems
s
_ Signature of Owner/ Lessee/Agee Signature of Contractor/Li nse Holde
STATE OF FLORIDA
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
this_Odayof(�r,QT 20L(e by
STATE OF FLORIDA
COUNTY OF wdm
The forgoing instrument was acknowledged before me
this �ndayof RL[20 I fo by
QN
BRUCE M TYRRELL, JR. Bruce M Tyrrell, Jr.
(Name of p Fon acknowledging) (Name of pe acknowledging)
ature of NotaryPu c- State of Florida ) (Signature of Notary Pu 'c- State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
#FFBa54�6 . "EXPERE&JAN22,2018
'CIAELVASA Commission No. #FFaa547s „� (S �yjRICIA A. KELVASA
Commission No. �r •"� MY�C''0}(�MISSION#FF0M76
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2 201 EXPIRES: JAN 22, 2018
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Revised 07/15/2014
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