HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: February 21, 2018 Permit Number:
• RECEIVED
Building Permit Application M,AR 01 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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
PROPOSED IMPROVEMENT LOCATION:
Address: 9301 Natures Way, Fort Pierce, FL 34945
Legal Description: PALM BREEZES CLUB (PB 49-32) BLK 4 LOT 23 (OR 3534-1031)
Property Tax ID#: 2310-500-0117-000-6 Lot No.23
Site Plan Name: Puangporn Pooritheerangkoon Block No. 4
Project Name: Puangporn Pooritheerangkoon
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
Installation of thirteen (13)Accordion Hurricane Shutters
CONSTRUCTION INFORMATION:
Additional work to b rtormed under this permit—check aMShutters
apply:
HVAC Gas Tank ❑Gas Piping Windows/Doors
11 Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 5,272.26 Utilities:cn Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Puangporn Pooritheerangkoon Name: Miriam Van Tassel
Address:9301 Natures Way Company: DVT Hurricane Shutters Inc
City: Fort Plerce State:FL Address: 3100 N Kings Hwy
Zip Code: 34945 Fax: City: Fort Plerce State:FL
Phone No.561-699-4956 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.
SUPPLEMENTAL CONSTRUCTION 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: 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.
Signatu a of Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORISQA, 1-yc�e
COUNTY OF !Sk . LU COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged efore me
this \ day of TNIrA f 20-\!kby this-\: day of W%4{ 120_11 by
yN �4 Via► ^ V *%"n 'CgSStI t\11 a,nn J.kM �a►SsQ�
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 " iN L- Produced D L-
(Signature of Nota yt:ob 'Sfi�te a res (Signature of Nota rt Public-St to of Floa
v cc:07-12023 n
Commission No. "'IIIh,S�'t!n 2020 Commission No.
C denurite, -
ST. Lucie County, Per ~vF�A :STri'LtiCis�Gounhye P�rr�tiin�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA
IZA 71 112
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17