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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11� 1 Permit Number:
•
Building Permit Application �
Planning and.Development Services N O V 1. 5 201
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Resi&Atial° "'°"'°"°'°
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: q50 2 Crook-1, aok
Legal Description: TbQ l$ P(KD l( �F1 Lo-4-
PropertyTax ID#: � -1 - ' 64- 000ra- ter, - 3 Lot No. Ha Pt
Site Plan Name: %Z C 9-1 k QSALd,, Block No.
Project Name: i= +ZAP h YAC Cu
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (13 ) MIAMI DADE APPROVED ACCORDION SHUTTERS
CONSTRUCTION INFORMATION:
Additional work to e performed un er t is permit-check a appy:
HVAC 11 Gas Tank []Gas Piping �_Shutters Q Windows/Doors
Electric 0 Plum ing Sprinklers []Generator D Roof Roof pitch
Total Sq.Ft of Construction�Cl5_U 01 G� Sq. Ft.of First Floor:
4
Cost of Construction:$ Utilities:[]Sewer OSeptic Building Height: 15'
OWNERAESSff: CONTRACTOR:
Name A( Name: SAMULE ZAZA
Address: 9`508 Ci e '5'id9_ Lo. Company: JUST SHUTTER IT INC
City: r7t. L A-CAQ Stater Address: 1029 SW S. MACEDO BV
Zip Code:i�l[Q!R(P Fax: City: PORT ST LUCIE State:FL
Phone No. '"17a - ,an 1 -qol I of 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@GMAIL.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 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 f' st inspection. If you intend to obtain financing,consult with lender or an attorney before
commencM work or recording our Notice of Commencement.
s
'SO4ture of Owner/Lessee/Cont or as Agent for Owner gnature of Contractor/License Ho er
STATE OF FLORIDA�^11 STATE OF FLORID
COUNTY-OF ��st .L s Q�2, COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this�U day of . 20 _ by this-36 day of (3C". .20 _LJ_by
J, z� o -
(Name of person acknowledging) (Name of person acknowledging)
( ignature of Notary Public-State of Florida) (Sigifature of Notary Public-State of Florida)
Personally Known _P OR Produced Identification Personally Known "Q OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. QG 0 6106G l0 I
'0Y n& Notary Public tate of Florida Y v
Parrish A Ni hots =o+�` oqG^ Notary Public State of Florida
4 ,PQ My Commission v My Commission GG 126706
Revised 07/15/2014 �,,Rd` Expires 07/20/2021 ytFer M1�° Expires 07/20/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS