HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (O- 15 Permit Number:
Building Permit Application
Planning and Development Services
�i� �' es'
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Sr. Lucie C;cra1gv, P!_
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: -71 a,p MCUd(1-btuL 7r.
Legal Description: MCQ GIS�0 VLL CPR 4'q- l la 104- q'S (b 9- ?7?,QQ - a-7291)
Property Tax ID#: n L - 06f\ - 1 Lot No. a S
Site Plan Name: V,-nY_ mF dlamJ1*)a__, Block No.
Project Name: o rY `'
� p� T P(V� 0
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of( ()Miami Dade Approved Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work to be nprtormed under this permit-check a appy:
HVAC Gas Tank ❑Gas Piping IZI Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ Z(2 OO•� Utilities:0Sewer 0Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name f—\Ct cg- Mgn2a Name: SamuelZaza
Address: -11 ao UckLdSion _C)r-. Company- lust Shutter it Inc
City: Port St Lucie State:FL Address: 1608 SW Taurus Ln
Zip Code: 34986 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: justshutterit@gmaii.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 thepermit 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.
C19w4ture of Owner/Agent/Lessee Si ure of Contractor/L ense Holder
STATE OF FLORIDA ��ll 11 STATE OF FLORIDA�1 )
COUNTY OF ( ?-i _ l �AOJICJ COUNTY OF
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The forgping instrument was ackilowledged before me The forErng instrument was acknowledged before me
this�day of 20 14 by this�day of jl 20__1A by
(Name of person acknowledging) (Name of person acknowledging)
(Signat re of Notary Public-State of Florida) (Signa of Notary Public-State of Florida)
Personally Known_)6MOR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. I aG7()�n F164011+_ Notary Public Stat �i Qdssio No.��yl�f�?d o (Seal)
Parrish A Nicho s
My Commission G 126706
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Revised 07/15/2014 roomy P��� Notary Public State of Florida
Parrish A Nichols
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07/20/2021
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