HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICALE INFO(MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (I Permit Number:
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 xxx
PERMIT APPLICATION FOR: Shutter
PROPOSED -IMPROVEMENT LOCATION:
Address: ? 7 3 3
Legal Description: / 1�f z7�
_Ca 7
Property Tax ID #: 1:� -�) 22 - -t dv O i3 10 - Ud U
Site Plan Name:
Project Name: t GJC
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
INSTALLATION OF ( ) MIAMI DADE APPROVED ACCORDION SHUTTERS
Lot No. �r
Black No; r�
Haaitionai work to be nertormea under tnls permit— check all that apply:
HVAC I _I Gas Tank []Gas Piping W_ Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers LJ Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ y5-0 - Utilities: _ Sewer 0 Septic Building Height: 15
OWNER/LESSEE:
CONTRACTOR:
Name 2 q 1 lor' U& ril'f'o
Name: SAMULE ZAZA
Address: -7-T53 Gr w-va 11�r i g (& it
Company: JUST SHUTTER IT INC
Address: 1029 SW S. MACEDO BV
City: 10S State: r4r
Zip Code _P4 i Fax:
City: PORT ST LUCIE State: FL
Phone No. �� �- "Zd �� % 9
Zip Code: 34984 Fax:
E -Mail:
Phone No. 772-201-9919
E -Mail: JUSTSHUTTERIT@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
State or County License: 24294
from the Owner listed above)
IT value OT construction is $ZSUU or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTI N LIEN LAW -INFORMATION: =
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: I Not Applicable
Name:
Name: ?�
Address:
Address:
City: State:
City: State:
Zip: Phone:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:Not Applicable
A
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 subjectstructure
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 firs- inspection. If you intend to obtain financing, consult with lender or an attorney -before
comnAncing 4o*.Qr recording vour Notice of Commencement.
re of Owner
as Agent for Owner ( I SXhature
STATE OF FLORID
COUNTY OF
The f ip instru t wad �cknowledge�Fi fore me
this '/�r�`-' day of ✓' C� 20Z_by
�SW�Yye &- 7y`C-Ti-A-
(Name of person acknowiedging )
lam`
(Signature of Notary Public- S ate of Florida)
Personally Known J� OR Produced�(��
Type of Identification P oduced �� �►�� _ F�/��.
Holder
STATE OF FLORIDA II
COUNTY OF
The orgA.Vg instrument was acknowledge$�fore me
thi�y of �l G' 20 l by
5� a-eC/" - 7� kl*-
(Name of person acknowledging)
(Signature of Notary Public- Stat4 of Florida )
Personally Known v"` OR Prod
Type of Identification Produced^
f°' �Y' 'moi
Commission No. !� y�'•,c!!� ��i'tl�aa"�
p-
Commission No. / d��—
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