HomeMy WebLinkAboutBuilding Permit Application p
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11 l �1 Permit Number:
- _ �
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division 13Y. """"""'
2300 Virginia Avenue, Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 9037 Champions Way, Port St Lucie
Legal Description: Lakes at PGA Village (PB 43-32) Blk A Lot 26
9037 Champions Way, Port St Lucie
Property Tax ID#: 3334-501-0040-000-5 Lot No.26
Site Plan Name: Grayson Block No. A
Project Name: Grayson
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be ertormed under t ispermit—check a appy:
HVAC Gas Tank F]Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ o7s 5 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Robert Grayson& Rita Turner Name: Edward J Heritage
Address:9037 Champions Way Company: Folding Shutter Corp
City: Port St Luce State:FL Address: 7089 Hemstreet PI
Zip Code: 34986 Fax: City: West Palm Beach State: FL
Phone No.302-419-5654 Zip Code: 34986 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: = Not Applicable BONDING COMPANY: x 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 thepermit 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.
s
Signature of Own or as Agent for Owner Signature of Contra er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The for Ding instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of C)--T— , 20 Q by this I Sday of dcT— 20 IZ_by
EDWARD J HERF+AGE EDWARD J HERITAGE
(Name of person acknowledging) (NaL2,
e of person acknowledging)
,
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida )
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. �F9 Q-7 (Seal) Commission No. FF l SD 01 G'� (Seal)
Wy PAMELA A.EVAN PAMELA A.EVANS
NOTARY PUBLIC
STATE OF FLORIDA STATE OF FLORIDA
Revised 07/15/2014 Comm#FF150967Comm#FF 150967
e s�NCE 19�e
10/11/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS