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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I W a' 0191
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce R 34382
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR: . Wihatvw
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PROPOSED IMPROVEMENT LOCATION: j f
Address: 6109 Raintree Trail,Fort Pierce,FL 34982
Legal Description:INDIAN RIVER ESTATES-UNIT-09-BLK 71 LOT 36
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Property Tax ID#:3402-610-0058-000-7 Lot No.36
Site Plan Name: Block No.09
Project Name:Wayne A.Teegarden
Setbacks Front Back: RightSide: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace 5 windows =M p0c:F
CONSTRUCTION INFORMATION:
t ona wor to a orme under t s permit–c ec aM,—appfy:
HVAC 13 Gas Tank ❑Gas Piping _Shutters L2 Windows/Doors
0 Electric 0 Plumbing Sprinklers Generator 1:1 Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 14,120 Utilities Sewer I Septic Building Height:
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OWNER/LESSEE: CONTRACTOR `n
Name Wayne A.Teegarden Name:Toby Tokes
Address: 6109.Raintree Trail Company:Armorvue Window&Door
City: Fort Pierce State: FL Address:1000 Clint Moore Rd Ste 109
Zip Code: 34982 Fax: City:Boca Raton State:FL,
Phone No. 772-940-2715 Zip Code: 33487 Fax:
E-Mail: Phone No. 561-9884222'
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:CRC1330842
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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 Counttyy 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 of an attorney before
commencing work or recordingyour Notice of Commencement.
Signet e-of`OwneF 'errt/1essee Signatu . of Con ct' /License Holder
ST E OF FLORIDA STATE OF FLORIDA
COUNTY OFSf LkCi a COUNTY OF&/Ai 8e�aaAi
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this-8 day of ,Dec 20/6 by this_day of gV - I 20,,*by
&Gea P 6 7-o kip r
(Name 6f person ackn ledging} (Name of iferson acknowledging)
Signature of Motary Public-State of Florida} Signature of Wary Public-State of Florida}
Personally Known ✓ OR Produced Identification Personally Known ' %.o'11OR Produced Identification
Type of Identification Produced Type of Identification Produced
�ptp� Victoria Lee Murrell icagy vctgda L�Murrell
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Commission No. n
Revised 07/15/2014 NOWAJ PUBLIC Commission No. ' s NO UBLIC
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STATE OF FLORIDA .-STATE OF FLORIDA
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIONI SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW „ REVIEW REVIEW
DATE
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