HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO/MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /7 Permit Number: / b �-�/ 0
RECEUVED
Building Permit Application JUN 19 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
L , PO5E6lMR01lEMENTrIC`CATIQIN
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Address: 5310 DEER RUN DR
Legal Description: HOLIDAY PINES S/D PHASE III LOT 498
Property Tax ID#: 1313-502-0075-000-1 Lot No.498
Site Plan Name: Block No.
Project Name: COOK
Setbacks FrontX Back: X Right Side: X Left Side: X
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D " 1l.Ea D5f PTIC?N Ql `WORK'S "
INSTALL 11 CRANK ROLL UP SHUTTERS
CC?`N�STRUCTfC?I 1NFORMATIO,N '
Adclitional work toa ne orme under this permit—check�a ' appy:
HVAC 11 Gas Tank Gas Piping Shutters Windows Doors
11 Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 10,693.00 Utilities:Sewer Septic Building Height:
MW L't-, CONl'RAC1'QR
Name CLAYTON AND SUSAN COOK Name: Michael Heissenberg
Address:5310 DEER RUN DRIVE Company: Expert Shutter Services
City: FORT PIERCE State:FL Address: 668 SW Whitmore Dr
Zip Code: 34951 Fax: City: Port Saint Lucie State:FL
Phone No. �� { 15- Zip Code: 34984 Fax: 772-871-0990
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: Callexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not A licable
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,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 attorne before
commencing work,0-r_r_e_c_o_NiMyour Vtice of Commencement.
s
Signature of Owner/Le see Contractor A Agen for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �� 11, a JL CA COUNTY OF S5�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 01 day of,�jrtic 20 1'1 by this(71 day of JuYtiG 20 171 by
(Name of person acknowledging) (Name of person acknowledging)
Pature ofota Public-State of Florida) (S' nature of ota Public-State of Florida)
Personally Known �//OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.c-. G Ak(Sea4qa*h Russell Commission NoCxGn IO%3 RusseN
NOTARY PUBLIC NOTARY PUBLIC
STAT
Revised 07/15/2014Comm#GG106399 Comm#GG108399
W0- 1Expires 5/25/2021 e, Expires 5/25/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS