HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: [(Y� - 0 IQ
:5�1_
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 xx
PERMIT APPLICATION FOR: Shutter
:PROPOSED IMPROVEMENT LOCATION: j; §
Address: glal Cod r\ovs}I.e_ 9L.
Legal Description: PC)Q aQC. A�17 —r-AA F IL E—SE QVEE Q VLZ CAs,-m r D tye
Property Tax ID#: 3?)al- X03- CO?--g�— DOO— 7 Lot No. ®�
Site Plan Name: �0 Block No.
Project Name: so 0
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of(I J)Miami Dade Approved Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work toe Derformed under this permit—check all appy:
HVAC 0 Gas Tank Gas Piping �MGenerator
Shutters E]Windows/Doors
Electric Plumbing Sprinklers E Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ �1 �p 0 U Utilities: Sewer Septic Building Height: 15
OWNER/LESSEE: CONTRACTOR:'
Name Soo Name: SamuelZaza
Address: AI(Al (:�&rrlbu l-re. Company: Just shutter it Inc
City: Port St Lucie State:FL Address: 1608 Sw Taunus Ln
Zip Code: 34966 Fax: City: Port St Lucie State:FL
Phone No.772-201-9919 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-201-9919
Fill in fee simple Title Holder on next page(if different E-Mail: iustshutterit@gmall.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 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 m,ay result,in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before th first inspection. If you intend to obtain financing, consult w' h lencI7 or an attorney before
commenfing wcitk orrecording our Notice ommencement.
Sign ure of Owne /Agent/Less ,_j!pafure of Contractor/License Holder
STATE OF COUNTY OF FLORIDA l ` ��\_ COUNTY OF STATE OF FLORIDA 1' ��
The g Wnstru *nt was ac nowledge efore me The f gwg instru ent was !cknowledged before me
this day of 20�by this�day of 20JI by
A-V-',,A Z V-1— S'dry„��tet,(� :7, 7�A
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Knowr"L_/_OR Produced Identification
Type of Identification Produced Type of Identification Produced
cl
Commission No. OJ \-I?/z Commission No. �� OZZ (Seal)
a°� MICHELLFREDERKS ?°���"�u°��o MICHELLFREDERICKS
* * MY COMMISSION#FF 5422 * MY COMMISSIONA FE 905422
S:August 2,2019 �� EXPIRES:August 2,2019
Revised 07/15/2014 ���oa Bonded Thru Budget Notary Servkes 'kOFgo'*'Tin 0- FNotarySerrkes
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA'TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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