HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I qL0 _ 1)
s
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 x
PERMIT APPLICATION FOR: Shutter
PROPU5ED.1!fR OV MENT,LC3CATI N
Address: 6200 SPRING LAKE TER., FORT PIERCE, FL 34951
Legal Description: PORTOFINO SHORES PHASE 3, (PB 43-40)LOT 370 OR 3398-2119
i
Property Tax ID#: 1312-503-0143-000-9 Lot No.370
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESF tNORIC
INSTALLATION OF HURRICANE SHUTTERS
CdNSTRUCTIt N INFORItIiA N w
Y
Additional work to fl
orme un er t is permit—c ec a appy:
HVAC Gas Tank ❑Gas Piping V Shutters Q Windows/Doors
Electric Plumbing Sprinklers 11 Generator E1Roof Roof pitch
Total Sq. Ft of Construction: / S Ft.of First Floor:,
Cost of Construction:$ �( 9�e��0 ✓ Utilities,- Septic Building Height:
OWNER/LES
Name MARY K CULLY Name: JAMES SILVIA
Address:6200 SPRING LAKE TER Company: PALM COAST FLORIDA COMMERICAL DEVELOPMENT,LLC
City: FORT PIERCE State: FL Address: 505 BEACHLAND BLVD.,#2
Zip Code: 34951 Fax: City: VERO BEACH State:FL
Phone No. Zip Code: 32963 Fax`. 772 299 1958
E-Mail: Phone No. 772 299 1955
Fill in fee simple Title Holder on next page(if different E-Mail: GIOVANNA@PALMCOASTSHUTTERS.COM
from the Owner listed above) State or County License: CBC1258218
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
St1PPLEME14 L C€?NNLIESTRUCT! N(LAW INFORIWATIQN W
,�. ... �w .�. ....
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: WA Name: N/A
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: NIA Name: WA
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 fina cing,consult with lender or an attorney before
commencing work or recording our Notice of Co encement.
k- S� S
Signature of Own e r/LessE@Xontractor as Agent forner Signature of Co ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF .�i�/��Z4,1 '�1✓��Z
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this,&day of 20/_? by this c9 l day of 15 20 1—+_by
1 go �%�/FS; ✓l✓-I-
Tame of:kacknowledging) (Name of p acknowledging)
(Signature of Notary Public-State of Florida) (Signatur of P
�a+Pv No ; ublic state of Florida
Personally Known OR Produced Identification 10 Personally K °�h 16taryM RMI ef1 ficat n
Type of Identification Produce °4;+ ° 4 Rrr„;, ° �T a of Iden i* o6w&trMlssion'T t930
ter;roV a U V S:.M10 �, .,C:d o' Expiresu!l2elea 19
Commission No. /�/ Fr (Se1[iV11�55iC:! >> _ wti5 Commission
`v_ (Seal)
`•6�, w !1"1La7.�5:.{1::�i ;�e?I ail AP 1 J
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
IN ITIALS