HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: g• Permit Number: ;l7/, ?. V 4q a
Building Permit Application DEC 19 2417
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 xxx
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 2-70H --y-cY nD,7 Cafe170IY.\ lZ�
Legal Description: Tt]yy\PSbY1 1T- Oty'1-�- �lJ�� f�`� 1�C-114 V
Property Tax ID#: 33a—[ " —7 OLA— M k I— CL0 — LA Lot No. V
Site Plan Name: "ria Al S Block No.
Project Name: Y7!r D G-V,I S
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF MIAMI DADE APPROVED ACCORDION SHUTTERS
CONSTRUCTION INFORMATION:
Additional work toe performed under this permit-check all appy:
HVAC 0 Gas Tank Gas Piping Shutters Q Windows/Doors
Electric Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost
Cost of Construction:$ a Utilities:�Sewer❑Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name I— , Name: SAMULE ZAZA
Address:J-I0 y — A'N0YY\DS U,(\ 7n Company: JUST SHUTTER IT INC
City: State: Address: 1029 SW S. MACEDO BV
Zip Code:an 2(n Fax: City: PORT ST LUCIE State:FL
Phone No. -n a - a(�j 1 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: :
DESIGNER/ENGINEER: of Applicable MORTGAGE COMPANY: ' Not Applicable
Name: f " Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: �Oot 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
commerwing work or recording our Notice of Commencement.
� A A - / Z�zu/( s
SreW Owner/Lessee/C V
actor as1`ent for Owner S ature of-contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF {-. I,I,LQJL1E COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1"-� day of j)e. , 20 nby this a day of DQ-C— .20�.n_by
(%-t� 7_q_ Qa® F)aXy-\ Q�,--
(Name of person acknowledging) (Name of person acknowledging)
( gnature of Notary Public-State of Florida) ignature of Notary Public-State of Florida)
Personally Known 0 OR Produced Identification Personally Known '�Cl OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.a „ 70 6 (Seal) �Fld,
mission No. C6 , Se I
Notary Public State of F 'tla
r° Parrish A Nichols r :; Q My Commission GG 126 6
Revised 07/15/2014 a My Commission GG 126706 •r €° Expires 07/2012021
VI moi' Expires 07/20/2021 N�
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS