HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
a
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 IMPR011EMENT LOCATION:............................................................................................................................................................................................................................
.
Address: 5702 Paleo Pines CIR Fort Pierce, FL 34951
Legal Description: HOLIDAY PINES S/D-PHASE I- LOT 32 (MAP 13/12N) (OR 3744-1389)
Property Tax ID #: 1312-500-0033-000-6 Lot No.
Site Plan Name: — Block No,
Project Name: branca
Setbacks Front ___ Back: Right Side: _ _Left Side:
— - -- --
_. ._........ - ---------
'DETAILED DESCRIPTION OF WORK:
1_._-_—._.--.__.._. .......................... ........._......_....._................................._____..........--_................_............................................................._......_..............____....____..............................._............-___.._.__._.............__.-____..._-_.... ..__ _-_.._._.__..__._.........._..................................._
-
REPLACEWINDOWS WITH IMPACT
CONSTRUCTION INFORMATION: --------- - ------
---�
Additional wo—rk to e er orme un er t is permit - c pec < a app y: --
F1HVAC F] FI
Gas Tank F]Gas Piping
Shutters a Windows Doors11 ,
Electric ❑ Plumbing Sprinklers 11 Generator F]Roof
Total Sq. Ft of Construction: Sq. of First Floor:
—]Sewer
_
Cost of Construction: $ 7599.00 Utilities: a Septic Building Height:
_
OWNER/LESSEE:
CONTRACTOR:
Name Elena Branca -- —
Name: Bruce M Tyrrell. Jr
Address: 5702 Paleo Pines CIR
Company: Kamrell Windows & Doors
City: FORT PIERCE State: FL
Address: 2441 SE Golfwood Drive
Zip Code: 34951 Fax: —
City: Stuart State: FL
Phone No. 772-618-0879
Zip Code: 34996 _ Fax: 772-288-6208
E -Mail: ELENAMARIASTEWART@YAHOO.COM
Phone No. 772-288-6205
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: pati.kelvasa@kamrell.com
State or County License: CGC061180
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:
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 bylaws
rules, 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.
s
_ Signature of Owner/ lessee/ nt
Signzrture of Contractor/LicemfHolder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF Martin
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this �( day of 2011--by
thisa I day of N n\je_.�h� 206 by
BRUCE M TYRRLLL, JR.
Bruce M Tyrrell, Jr.
(Name of person acknowledging)
(Name of person acknowledging )
ignature of Notary PUbkState of Florida)
Sig ture of Notary Public- ate of Florida )
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification Produced
Type of Identification Produced
IMIGIA
No. #FFoaSa7s KELVASA
XOMMISSION*FF08547
IBES: JAN 22,2018
Q80nded
PATRICIA A. KELCommission
ommission No. #FFoeSa7s :°` Yr`� ( �fMISSION#�FF08547g
through 1st Stall Insuran
EXPIRES: JAN 22,2018
"` Bon
Revised 07/15/2014
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS