HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q n
Date: January 18, 2018 Permit Number:
Building Permit Application JAN 2 3 2018
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 X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P`ROPOSED,yIIVIFRO. EMENT`.LOCATION`:
Address: 2675 Conifer Drive, Fort Pierce, FL 34951
Legal Description. Monte Carlo Country Club- Unit two-Lot 198 (OR 708-1182 : 886-2229)
Property Tax ID#: 1334-502-0079-000-4 Lot No.198
Site Plan Name: O'Grady Block No.
Project Name: O'Grady
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRI`PTION'OF 1NQRK: '! . .
Installation of two(2)accordion hurricane shutters and three(3)Nautilus roll up shutters-hand cranked
�C®NSTRUCTIONAN',FORMATIO'N:
Additional work toe nertormed under tispermit—check all appy:
HVAC Gas Tank []Gas Piping Shutters Q Windows/Doors
Electric O Plumbing OSprinklers O Generator O Roof Roof pitch
Total Sq.Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 16,191.69 Utilities:n Sewer OSeptic Building Height:
EhOWN,EFR/LESSEE:, CONTRACTOR:
Name Hedwig O'Grady Name: Miriam VanTassel
Address:2675 Conifer Drive Company: DVT Hurricane Shutters, Inc.
City: Fort Pierce - State:FL Address: 3100 N Kings Highway
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-460-2170 Zip Code: 34951 Fax: 772-794-1590
E-Mail: Phone No. 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail: dvthurricaneshuttersinc@hotmail.com
from the Owner listed above) State or County License: 24394
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
Sl1PPLElUIEN�ALC�3 NSTR CTIONL(EN 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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Signatur of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDAlh"* TATE OF FLORID
COUNTY OF b A; OUNTY OF
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The forgoing instr ent was acknowledged before me g e�Qr oing in ment was acknowledged before me *• =
thi�day of 206 by g i day zOf�•by o
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Name of per making statement Zi
Name of perso�aking statement o
Personally Known OR Produced Identification Q rsonally Known OR Produced Identification ' se.
Type of Identification -T pe of Identification Q s
Produced �p dJZ,/jp iauced NNT
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ACA0,4- 18zj —I
(Signature of ary Public-State of Klorida U (Signature of Nota ublic-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17