HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED „
Date: �\ ' ;7' 1L Permit Number: tU l O U
Loam
Building Permit Application NOV 0
`Planning and Development Services PEKIIITTiNG
Building and Code Regulation Division St. Lucie COUnty, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: . r
Uy ...r <sOR",
PIIPOS�D IMROVEEI T LQx �„„seCAT
Address: 5413 sunset blvd,Fort Pierce,FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT-08-BLK 58 LOT
Property Tax ID#:3402-609-0245-000-1 Lot No.
Site Plan Name: Block No.
Project Name:Kevin or Kathleen Purssing
Setbacks Front Back: Right Side: Left Side:
' ' a -s iv w x x a
Replacement of windows
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Additional work toa nprtormed under tispermit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 7500.00 Utilities: Sewer Septic Building Height:
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Name Kevin or Kathleen Purssing Name:Alphonse P. Campanelli
Address: 5413 sunset blvd Company:Storm Tight Windows,Inc.
City: Fort Pierce State: FL Address:500 SW 12th Ave
Zip Code: 34982 Fax: City:Deerfield Beach State:FL
Phone No. 772-301-8454 Zip Code: 33441 Fax:561-292-3562
E-Mail: Phone No. 561-536-4387
Fill in fee simple Title Holder on next page(if different E-Mail:stormtightpermits(&outlook.com
from the Owner listed alcove) State or County License:CRC046091
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DE5IGNER/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 certifythat no work or installation has commenced priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holderto 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.
krfl I_g-__� P r—C S c ae" d
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORID �11 STATE OF FLORIDA—P, 1 72
COUNTY OF /�i COUNTY OF
The
(ti bY�
The f instrumwas acknowledged before me The forgoing instrument was acknowledged before me
this day of V20 ley this day of M3%,/ ZOy
{N of person acknowledging) {Nam rson acknowledging
jA fiJ1iAC<:=
{Sig a re of Notary ic-State of Florida) (Signat a of Notary P -Sta a of Florida)
Personally Kno 'n ....,Ya feAl Identification Personally K �( t Produced Identification
Type of Identifi QC@Ehissi0ni 86143t;>, Type of Iden i0-4-,,Pr4�fi�tl��
Explres May , Yu
Boo 3B5 7019 '� i COf171i1Ea31®HF C�$$1
Commission No p �ir�°QCommission `� b� 43(
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•,�n��r7�,2020
Bma*gTh uTT0yFa;n"Sur"COBOD-385.1079
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS