HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: Permit Number:
J I R E C E I V .D N IV! 0 8 2016
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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: To Select from dropbox, click arrow at the end of line Windows &
PROPOSED IMPROVEMENT LOCATION: door
Address: 120 Beach Avenue:; Port St. Lucie FL 34952
Legal Description River Park Unit 3 Block 6 Lot 21
PropertyTax ID#: 3419-515-0064-000/2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove and replace windows, thirteen windows in six
openings. Remove and replace front entry door.
CONSTRUCTION INFORMATION:
Additional work to be Dertormed un er t is permit—check a appy:
[1
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:_- n/a Sc . Ft.of First Floor:
Cost of Construction:$ 10, 6 75 .0 0 Utilities: _Sewer Septic Building Height:
-- '= -N-E=R/%P E=E: _ 9 N RA TA
Name Mr. & Mrs. Richard Pokorny Name: Jeff Jackman
Address: 120 Beach Avenue Company: Master Craft Aluminum Prod.
City: Port St. Lucie State:FL Address: 1634 SE Niemeyer Circle
Zip Code: 34952 Fax: City:Port St. Lucie StateFL
Phone No. 71 6-374-5.987 Zip Code: 34952 Fax: 335-0860
E-Mail: Phone No. 335-1177
Fill in fee simple Title Holder on next page (if different E-Mailmastercraftaluminum@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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: 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 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.
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\1'A XL___ �\v s
_Signatu of` n r/L ss e/Agent Signa re f ntr c r/License Holder
STATE OF-FL�RIDA STAT LORIDA
COUNTY OF St. Lucie COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_I day of Nov _mfr 20 16by this 1 day of NpiXam.b_e__r_ 201-6_by
Jeff Jackman Jeff Jackman
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu lic-State of Florida) (Signature of Notary Publi State of Florida)
Sheryl D.Moore Sheryl D.Moore
- P-ersonally Known!OE:�"
�¢ +C-- --P-ersonall.y-Known - X - Of-P eldflFi FMl5 IG—
Type of IdentificatF FLORIDA Type of Identification Produced STATE irm
omm#FFS42382 Comm#FF542382
Commission No. 1/15/202() Commission No. ( fres 1/15/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS