HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE1 COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: / �• / Permit Number: /
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Building Permit Application
Planning and Development Services SAN 11 201
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: -2kAaq ge_k�ry �L
Legal Description: POO a"� Al- -h_ RDaXS�Q, lob El
Property Tax ID#: M(Q 1 - 000 O Lot No. 5
Site Pian Name: P, k� Se1CS►n-R-C Block No.
Project Name: IQAI
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF ACCORDION SHUTTERS
l U C r4�7 o vVr-a(
CONSTRUCTION INFORMATION:
itiona wor to e e orme under tis —checkpermit a appy:
HVAC 1,Gas Tank []Gas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers �Generator �Roof Roof pitch
Total Sq. Ft of Construction: S of First Floor:
Cost of Construction:d 21,00 G Utilities-12Sewer 0 Septic Building Height: 15
OWNER/LESSEE: ..CONTRACTOR:
Name Name: SAMULE ZAZA
Address: 81-AQ"Q Wr_W Company: JUST SHUTTER IT INC
City: {-VIL State: L Address: 1029 SW S. MACEDO BV
Zip Code: 314q Z_ Fax: City: PORT ST LUCIE State:FL
Phone No: 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 CONSTRUC- fON 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: of 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 Count 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,l 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,cons,qilt with lender or an attorney before
commencine work or recording our Notice of Commencement
S
;Sign ure of Owner/Lessee/Contractor as Agent for Owner S' nature of Contractor/License Holder
ATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 'F4 . Lan Q_ COUNTY OF 5-, b kUQ
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_;�4 day of was/ - . 20 L2by this_2a_day of Nov ,20 --f-by
Saws 70-x.— `66_4� zo,',
(Name of person acknowledging) (Name of person acknowledging)
(St of Notary Public-State of Florida) (Signature of Notary ate of Florida)
Personally Known_X OR Produced Identification Personally Known�OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No4164 )0(o seal C s i o. G l o ?6 6 (Seal)
Mnr xo Notary Public tate of Florida
orr� N t=
a` Q My Commission GG 126706 Parrish A iV :h01s
Revised 07/15/2014 ���M1d Expires 07120/2021 My Comrnissi�. GG 126706
or�o Expires 07:2012021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
[INITIALS