HomeMy WebLinkAboutBuilding Permit Application o qac ao 6 n
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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
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PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 10851 S Ocean Dr#97
Legal Description: Windmill Village by the Sea condominium No 1 Unit 97 and pro rata share in common elements
10851 S Ocean Dr#97, Jensen Beach
Property Tax ID#: 4511-810-0104-000-7 Lot No.
Site Plan Name: White Block No.
Project Name: White
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION: r� j
Additional work toe nertormed under this permit—check all that appy:
HVAC 0 Gas Tank ❑Gas Piping WShutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ ( 3 oe Utilities:0 Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:;
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Name William&Sharon White Name: Edward J Heritage
Address:10851 S.Ocean Dr#97 Company: Folding ShutteriCorp
City: Jensen:Beach .;. State:F� Address: 7.089 Hemstreet PI
Zip Coder 34951" Fax! City: WEst Palm Beach : '' State:FL
Phone No.772-233-6214•' ;,, ` Zip Code: 33413 Fax: 561-640-8204
E-Mail: Phone No. 561-683-481'1
Fill in fee simple Title Holder on next page(if different E-Mail: Info@foldingshutte'rs.com
from the Owner listed above) State or County License: SCC131151041
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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 Commencement6 *
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Signature of Owner/Le ee Co s Agent for Owner Signature of Contr a er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Pa1mBeach COUNTY OF PalmBeach
The fing instrument was acknowledgeAefore me The forgoing instrument was acknowledged before me
thisday of 0C-1— 20 I by this:day of dG:T_ 20 (7 by
Edward J Heritage Edward J Heritage
(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 Known xxxxx OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. f r— ISO !67 (Seal) Commission No. r ` � "G
I (Seal)
PAMELA A.EVANS
ARY PAMELA A.EVANS NOTARY PUBLIC
o< NOTARY PUBLIC STATE OF FLORIDA
Revised 07/15/2014 c STATE OF FLORIDA Comm#FF150967
Comm#FF150967 m 191® Expires
tis
Expires 10/11/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
=INITIALS