HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /&/,9-Date: . '� 'I Permit Number:
Building Permit Application DEC 2 2 2016
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
P14`oPQSED II IOROVEMENT LOCATION
Address: 3484 ROSELAWN BLVD, FORT PIERCE FL 34982
Legal Description: SUNRISE HOME SITES E/D BLK 1 LOT 9 (0.24 AC) (OR 1044-979)
Property Tax ID#: 2428-702-0009-000-8 Lot No.9
Site Plan Name: SUNRISE HOME SITES Block No. 1
Project Name: JENNIFER SMITH
Setbacks Front Back: Right Side: Left Side:
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Acid itional work to be nertormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric ❑Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
8489:00 '
Cost of Construction:$ Utilities: _Sewer�Septic Building Height: 1 z.
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Name JENNIFER L SMITH Name: SCOTT BERMAN
Address:3484 ROSELAWN BLVD Company: FLORIDA WINDOW AND DOOR
City: FORT PIERCE State:FL Address: 7108 FAIRWAY DRIVE#120
Zip Code: 34982 Fax: City: PALM BEACH GARDENS State:FL
Phone No.772-46875965 Zip Code: 33418 Fax: 561-624-8037
E-Mail: Phone No. 561-340-4300
Fill in fee simple Title Holder on next page(if different E-Mail: HOWARD@FLORIDAWINDOWANDDOOR.COM
from the Owner listed above) State or County License: CGC1509450
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER ENGINEER: Not Applicable pp MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: XNot 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 thepermit 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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_Sig tur of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF "F-�y U,)CIIL COUNTY OF PAL,BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of �2� 201�by . this day of ._:�r:> !�c°�,20 by
JENNIFER L SMITH SCOTT BERMAN
(Nam of person acknowledging) (Name of person acknowledging)
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(Sign ure oT otaryublic-State of Florida) (Signature of Notary Public-Sta teof Florida)
Perso ally Known OR Produced Identification s Personally Known xxx OR Produced Ide I icat/ion
Type of Identification Producedt-�t�L Type of Identification Produced
Commission Nol7p�Clq-3Al (S NOTARY mission No. lavPoa,, SIMKOFF
STAIR YFLORIDA * * MY COMMISSION 1{GG 013316
EXPIRES:-ftMv l27.T02D
�OFF��� BadedTkuBudp�Nobry
Revised 07/15/2014 00res 6/11/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS