HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Q
Date: �' ' ( I Permit Num ber: 11 ITS
S
ti_ w Building Permit Application NOV 15 2017
Planning and Development Services PER'1Al1TiNG
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce Ft 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 1220 NW Winters Creek Rd., Palm City , 1134990
Legal Description: HARBOUR RIDGE PLAT 17 TRACT G -10SAND PINE VILLAGE LOT 11
Property Tax I D#:4423-701-0015-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Sara Hazelton
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of Hurricane Protection
CONSTRUCTION INFORMATION:
Additional work toe er orme under this permit—check a appy:
❑HVAC E]Gas Tank ❑Gas Piping In Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers OGenerator ❑Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 22,962.81 UtilitiestSewer❑Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Sara Hazelton Name:Robert Altino
Address: 1220 NW Winters Creek Rd. Company:Galeforee Hurricane Shutters,inc.
City: Palm City State: fl Address:7636 South Federal Highway
Zip Code: 34990 Fax: City:Port St. Lucie State:FI
Phone No. 772-336-5177 Zip Code: 34952 Fax: 772-621-8159
E-Mail: Phone No. 772-337-6200
Fill in fee simple Title Holder on next page( if different E-Mail: galeforcetc(&email.com
from the Owner listed above) State or County License:CBC:1251430
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 holderto 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.
Hato of Owner/Agent/Lessee ature of Contractor/License Holder
STATE OF FLORIDA �� STATE OF FLORIDA
COUNTY OF COUNTY OF
The fqLgoing instrumAe��w1a�acknowledged efore me The forgoing instr uyas acknowledged before me
this day of _20 by this� ru day of ( V 20_ff by
(Name of person acknowledging) (Name of person acknowledgingAA
)
tS — �—
(Signature of Notzi1y Pu lic-State of Florida} (Signature of Notary Public-State of Florida}
Personally Known OR Produc d Identification V'l Personally Known OR Produced Id ntification
Type of Ide Type of Identification Produced
KAREN S. NIE SEN
`''�•'' ""11 11 KAREN S. NIELSEN
COmmi55io Commission M FbJJ6637
y n# FF 145,190
0.5 ommission Expires
June 1 2, 201 8 �; My Commission Expires
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS