HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: February 20, 2018 Permit Number:
� RECENEL
Building Permit Application
Planning and Development Services FEB 2 201
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Coun"
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: 351 Notlem Drive, Fort Pierce, FL 34982
Legal Description: Lot: 9, 10, 11, 12, Block: 3, Subdivision: Ruhlman
Property Tax ID #: 3403-805-051-000/9 Lot No. 9,10,11,12
Site Plan Name: Melinda Buckley Block No. 3
Project Name: Melinda Buckley
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of a total of fourteen (14) Hurricane Shutters - 8 Accordion Hurricane Shutters and 6 Bahama Hurricane Shutters
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit —check all appy:
HVAC 11
_I Gas Tank ❑Gas Piping `� Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 10,066.70 Utilities:cnSewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Melinda Buckley
Name: Miriam Van Tassel
Address:351 Notlem Drive
Company: DVT Hurricane Shutters, Inc
City: Fort Pierce State:FL
Address: 3100 N Kings Hwy
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-607-1309
Zip Code: 34951 Fax: 772-794-1590
E -Mail: mellyandjeff@gmail.com
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.
SUMLEMEIr TIAL CONSTRUCTION LIEN LAW 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:
BONDING COMPANY: Not Applicable
Name:
Address:
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 recording your Notice of Commencement. „
J��n
Signature of Owne / Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged efore me
this day of % 20by
M - (,-" &"r� V Pry, e L_
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced T) ✓_.
(Signature of Notary Public- State of1Florida )
Commission No. (Seal)
LASHAHNA INGRAM
Notary Public -State of Florida
-Mv Comm xpire, Dqc 20
1(u�\0
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF , -r 1. cJCy t
Theforgoing instrume t was acknowledged before me
this fmay of '-&-110 ZO f by
fY-\ it'r ,ivy L)Avj
Name of person making statement �—
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State bt Florida )
Commission No.
(Seal)
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Rev. 8/2/17