HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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I 1Xf 24 2011 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 xxx
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: CI 10, Ox'-
LegalDescription: ( a ��� O-7 14 0l 1I a Okk U -A 1-3 2 tc n (—O 7 _
Property Tax ID#: Sa l- DIMS-6 00 'Lot No. �
Site Plan Dame: R=0W10- /� Block No. _
Project Name: �7 f lqk�
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF ( °I ) MIAMI DADE APPROVED ACCORDION SHUTTERS
CONSTRUCTION INFORMATION:
Additional worctoe e orme un ert ispermit-checka appy:
HVAC Ei Gas Tank Das Piping �_Shutters ❑.Windows/Doors
Electric ElPlumbing Sprinklers 11 Generator Q Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: 1313 Utilities:n Sewer E]Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name 'LoWrd- (-�C ybPA— Name: SAMULEZAZA
Address: 9233 C\rej& Company: JUST SHUTTER IT INC
City: PG,rt (�4• f- State: Address: 1029 SW S. MACEDO BV
Zip Code: 34"4 Fax: City: PORT ST LUCIE State:FL
Phone No. 7-)2- 7c►l- qc�Lq Zip Code: 34984 Fax:
E-Mail: -- Phone No. 772-201-9919
Fill in fee simple Title Holder on next page(if different E-Mail: JUSTSHUTTERIT@GMAIL.COM
from the Owner listed above) State or County License: 24293
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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 TITLEHOLDER: WNotApplicable BONDING COMPANY: �)7Vot 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.
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
Signature of Owner essee/Contractor as Age r Owner Si nat of Contractor/License HdOr
STATE O ORI¢A' STATE OF FLORIDA
COUNTY OF M r d LAC,_ COUNTY OF C ��-
The forgoDg instrumen w s acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 l7 by this &' r-;- V-11-of v"`�� 20 LZ by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-S ate of Florida) (Signature of Notary Public-Sta a of Florida) r
Personally Known OR Produced Identificati y Personally Known OR Produced Ide �/1wo'.
Ro
Type of Identification Produced _ �� N:l ► tz Type of"Identification Producedy��
Commission No. rf ` <V')"- ( �) yGptt;MlSslpy mission No ��/ �� �� ` 'f( a`4� qugusr2J��°o9
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Revised 07/15/2014QA Cn
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DATE
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