HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE I FOM STE OMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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` 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
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 40 Lagos del Norte, Ft Pierce, FI 34951
Legal Description: YD Uds " Qt A C Spa,,;A LeLJq s b A,, -r C! V;I(Aj&
)
Property Tax ID#: / 301- D i7 d Uow!5- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION
`OFINORK:.
n cCuf-d,,n shy.#C,s O✓! tke him.
:CONSTRUCTION INFORMATION: ,
Additional work to be Dertormed under t hispermit–check a [11 appy:
HVAC Gas Tank Gas Piping —Shutters Windows/Doors
❑
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ �/DU Utilities: Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name Ron Forrest Name: Jeff Jackman
Address:40 Villa Blanca Company: Master Craft Aluminum Products
City: Ft Pierce State:_ Address: 1634 SE Niemeyer Cir
Zip Code: 34951 Fax: City: Port St Lucie State:FI
Phone No.401-231-2352 Zip Code: 34952 Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page(if different E-Mail: mastercraftaluminum@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.
AILIPPLEMENTAL CONSTRUCTION LIEN`LAW INFORMATION
DESIGNER/ENGINEER: XX Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X 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 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 dohereby 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
'ed
Sign r f n /Les a/Contractor as Agent for OwnerSi u C tracto License Holder
STATE OF FLORIDA S FL A
COUNTY OF St Lucie COUNTY OF StLucfe
The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me
this_4L day of 2q _by this 6 day of f&f4��_ ,20 12_by
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(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Pu c-State of Florida) (Signature of Notary lic-State of Florida)
Personally Known OR Produced Identification Personally Known Y OR Produced Identification
Type of Identification Produced Type of Ide catioraR&lbce�i___
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NOTARY PUBLIC
Commissi NOTARYPUBUC (Seal) Commi t 'o .: IDA (Seal)
STATE OF
Canrn#FF94 ;.::;^'t' Comm#FF942302
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Expires 1/15/2020 ;,..0 fres
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE I
I
INITIALS I