HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:--/ 70�-v7l
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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
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 2748 Iroquois Ave, Fort Pierce . s t=
Legal Description: San Lucie Plaza s/d unit one blk 47 lots 33, 34&35
2748 Iroquois Ave, Fort Pierce
Property Tax ID#: 1428-702-1003-000-0 Lot No.33,34,35
Site Plan Name: Burns Block No. 47
Project Name: Burns
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:. i u;
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CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction- SFt.of First Floor:
�6
Cost of Construction:$ A 3 J Utilities: _Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR+
Name Ruth Burns&Ruth Dobbs Name: Edward J Heritage
Address:2748 Iroquois Ave. Company; ,Folding Shutter Corp
City: Fort Pierce State:FL Address: '7089 Hestreet Place
Zip Code: 34946.. Fax: City:.West'Palm Beach, State:FL
Phone No.772.801•=5105 Zip Code:,33413 ,, Fax: 561-640-8204
E-Mail: Phone No. 561-683-4811
Fill in fee simple Title Holder on next page(if different E-Mail: info@foldingshutters.com
from the Owner listed above) State or County License: SCC131151041
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: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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 attorney before
commencing work or recording our Notice of Commencement.
P, �; s
Signature of Owner/ ssee/Contr r as Agent for Owner Signature of ContaqE r i older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Beach COUNTY OF Palm Beach
The fo oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Vday.of 20 Zby this 15"day of 51-fr- 20 Z by
Edward J Heritage- Edward J Heritage
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known 41�011 Produced Identification Personally Known �� OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FFl 50 �L7 (Seal)PAMCommission No. FI✓1� y P(�( OWA A.EVANS
g& NOTARY N PUBLIA. C NOTARY PUBLIC
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STATE OF FLORIDA Comm#FF150967
STATE OF F1 0 IDA
Revised 07/15/2014Comm#FF150967 19° Expires 10/11/2018
wmavlEx ires 10/1112 18
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