HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED '
Date:—"- 1 % - 1l0 Permit Number:
Building Permit Application NOV 8 4-(i1��
Planning and Development Services PR.liir:
Building and Code Regulation Division St. Lucie
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
,
PRiPaS:ED i M:PROVf M EI !"LOCATION
Address: 9418 Bunting Ln, Fort Pierce,Fl 34951
Legal Description, MONTE CARLO COUNTRY CLUB-UNIT TWO
Property Tax ID#: 3 r 60 2-. Lot No.
Site Plan Name: Block No.
Project Name: Mitchell or Laura Hall
Setbacks Front Back: Right Side: Left Side:
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itiona work to be nerTormed unclerthispermit-cec a appy.
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❑GasPi Windows/Doors
Piping Shutters ❑
Electric ❑ Plumbing Sprinklers 0 Generator 0 Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 8792.00 Utilities: Sewer Septic Building Height:
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Name Mitchell or Laura Hall Name:Alphonse P. Campanelli
Address: 9418 Bunting Ln Company:Storm Tight Windows,Inc.
City: Fort Pierce State: Fl Address:500 SW 12th Ave
Zip Code: 34951 Fax: City:Deerfield Beach State:FL
Phone No. 614-747-6163 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(a,outlook.com
from the Owner listed above) State or County License:CRC046091
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
r5UPPLEMENTALCONSTRUCTION LIEiN LAW INFt RMATIQN: $
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 covenantsthat 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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Signature of Owner/Agent/Lessee Signature of.Contractor/License Holder
STATE OF FL q I STATE OF FLORI
COUNTY OF r IM ��� COUNTY OF G )vy, I
The fo oing instr ent was acknowledged efore me The fo oing instrumggn,t was acknowledged before me
this day of 20by this day of N61/ ,20_Zby
me of person acknowledging) {N a of person acknowledging}
l
(Signa6e e of Notary Pu is State of Florida} {Signa a of Notary Publi ate of Florida}
Personal) Known OR Pr ce entification l✓ Persona Ily Known z�OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. ission No.
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Eypir€s May 17,2020 'y�;;;�w �Itcs 110 17 b20
Revised 07/15/2014 "°^M1"' 'Ond�'��sY�®�,��nlieumnca600.3057019 R nJ�d7ry"'r
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS