HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: February 20, 2018 Permit Number:
� RECEIVED
Building Permit Application
FEB 2 0 1010
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County
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
PROPOSED IMPROVEMENT LOCATION:
Address: 6024 Indrio RD Apt 7, Fort Pierce, FL 34951
Legal Description: INDIAN PINES VILLAGE- BLDG L UNIT 7
AND PRO-RATA SHARE IN COMMON ELEMENTS (OR 3624-2727:3635-914)
Property Tax ID #: 1313-501-0091-000-6 Lot No.
Site Plan Name: David Dingley Block No.
Project Name: David Dingley
Setbacks Front _ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of Two (2) Accordion Hurricane Shutters
CONSTRUCTION INFORMATION:
Additional work to b rtormed under this permit — check all appy:
❑HVAC Gas Tank ❑Gas Piping Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S. FtFt.j of First Floor:
Cost of Construction: $ 1718.16 Utilities: L_J Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David Dingley
Name: Miriam Van Tassel
Address:6024 Indrio RD Apt 7, Fort Pierce, FL 34951
Company: DVT Hurricane Shutters, Inc
City: , Fort Pierce State:FL
Address: 3100 N Kings Hwy
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. 401-524-058434951
Zip Code: 34951 Fax: 772-794-1590
E-Mail:ddingley@cox.net
Phone No. 772-794-1581
Fill in fee simple Title Holder on next page ( if different
E-Mail: dvthurricaneshuttersinc@hotmail.com
State or County License: 24394
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
fAh ►t CONSIRUCTIOWIEN l.qW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
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 recordiniz vour Notice of Commencement.
Rev. 8/2/17
Signature of O ner/ Lessee/Contractor as Agent for Owner
Signa ure of C ntracto /License Holder
STATE OF FLORIDA ,
STATE OF FLORIDA
COUNTY OF 5t L -XIi)ar
COUNTY OF SJ L,__�c., -e—
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of �7.ei" 20A by
this ca_ day of C, 20� by
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Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification_
Type of Identification
Type of Identification
Produced ,bi_„
Produced 1,*), 4
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Rev. 8/2/17