HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: / _1�
MECEIVED
Building Permit Application JAN -11 2017
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: To Select from dropbox, click arrow at the end of line Windows
PROPOSED IMPROVEMENT LOCATION: .
Address: 9306 Treasure Coast Street Fort Pierce
Legal Description: Palm Breezes Club Block 9 Lot 9
Property Tax ID#: 2310-500-0165-000/7 Lot.No.
Site.Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace four windows & one sliding glass door with
PGT units. -
CONSTRUCTION
nits. _CONSTRUCTION INFORMATION:: `.
Additional work toe nertormed. under tispermit-check all hi
HVAC _Gas Tank ❑Gas Piping L—_I Shutters a Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction $_r�500_nn Utilities: Sewer ElSeptic Building Height:
F
WNERAESSEE: ;: CONTRACTOR:ame Ca rrc11 Kozlowski Name: Jeff Jackman
Address: 9306 Treasure Coast Street CompanyMaster Craft Aluminum Prod.
City: Fort- Pierce State:�L Address: 1634 Se Niemeyer,.,/Cir,Zip Code: 34945 Fax: City: PSL ' State: FL
Phone No. 466-2715 Zip Code: 34952 Fax335-0860
E-Mail: Phone No. -1-1c;-1177
Fill in fee simple Title Holder on next page (if different E-Mailmastercraftaluminum@gmail.com
from the Owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I '
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: x 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 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.
1.
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
Si atur ne /Lessee gent SiVretST L RIDSRICOUN St. Lucie CSt. Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9 day of January 20 17by this 9 day.of January 2017 b
— Y
Jeff Jackman Jeff Jackman
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public tate of Florida) (Signature of Notary Public-State of Florida)
Personally Known X OR ProducePersonally Known X OR Pro ced ification
Type of Identification Produce iC Type of Identification Prbrov
e
p. =FF9OF FLORIDASTATE R� ORIDA
Commission No. COn
Commission No. MYIf� 382
• ExPires 111512 w Expires 1/15/2020
Revised 07/15/2014
gEVIWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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