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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: l O(o° l'J"3Y
r.:
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
PR,OPOSEtD IIUL�PRO�UEMENT�LOCATIO'N
Address: 1507 NW LANCEWOOD TERRACE, PALM CITY FL 34990
Legal Description: HARBOUR RIDGE-PLAT 8- EAST HAMMOCK_VILLAGE UNIT 4 (OR 3873-2904)
Property Tax ID#: 4426-803-0014-000-6.. Lot No.
Site Plan Name: Block.No.
Project Name: JATLOW PATIO
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK =11K
INSTALLATION OF HURRICANE SHUTTER ON MAIN PATIO
CONSTRUCTI,bN INFORMATION
Additionalwork to ffGas
orme un er t is permit—c ec aappy:
❑HVAC Tank Gas Piping LJ Shutters Windows Doors
❑ p g ❑ /
Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 2880.00 Utilities:Sewer Septic Building Height:
Y01NN,ER/LES'S'EE CONTRACTOR' -
Name DAVID C JATLOW Name: JOHN C FISCHER
Address:1507 LANCEWOOD TERRACE Company: ARMOR SCREEN CORPORATION
City: PALM CITY State:FL Address: 2744 HILLSBORO ROAD
Zip Code: 34990 Fax: City: WEST PALM BEACH State:FL
Phone No.202.255.1679 Zip Code: 33405 Fax: 561.841.8892
E-Mail: Phone No. 561.841.8890
Fill in fee simple Title Holder on next page(if different E-Mail: installation@armorscreen.com
from the Owner listed above) State or County License: CGC1522990
1f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPP -E'IVIENTAL CONSTRUCTION LIEN LAW INIFORMATION T
. .. .,.:r. 5..._: 4.
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: 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.
In consideration of the granting of this requested permit, l 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
commencin work recor 'n our Notice of Commencement.
s
Signature o'f Ownlger/Le►►ssee C ntractor as Agent for Owner Signatur Contractor/License Holder
STATE OF FLSTATE OF
COUNTY OFO -I • � � COUNTY OFORIDA�� `�
The forgoi g instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�+ay of 20 Llby thiso&L-clay of (Y)0_�. 20 by
bauio�k C . 30'4 1101�
(Name of person acknowledging) __ (Name of person acknowledging)
LiA&�e4&4-L LAC)
(Signature of Notary Public-State of FI ida) (Signature of Notary Public-State of Florida)
Personally Known )c `/
OR Produced Identification Personally Known OR Produced Idgatificatign
Type of Identification Produce Type of Identification P N GOODJ2021
�;�".;P4•••,, HEATHER HARRINGTON
Notary Public,State of Florida
Commission No. '�' M'!CC{ �$�N$FF942534 Commission No. Mycomrt� jrsMar.23,
047
EXPIRES:February 24,202.0 No.0 G 1sondedThru Notary Public underwAer& Bonded thru Ashton Agency,Inc.(800)451
Revised 07/15/2014
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