HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �/N g
Date: wahe Permit Number: 1 1611(--) - u `,�
COC.I:NTY REC�/ED
F •L a R� F O R-
- APR � 7
Building Permit Application 2010
Planning and Development Services Pennittin9 Department
Building and Code Regulation Division S. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential o
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 7.130 M y s-I-; C, u/Gy
Legal Description: !,F VS 1-i ifi✓) e$ of 4 4 k 'e 12.eye rye.
Property Tax ID#: -33 22 — 1p;$b —AN 48--o CO - / Lot No. LS
Site Plan Name: Block No.
Project Name: n/CLL Cte.--C
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
AelL't.. 151,,,,,\\hc,r #o \ o v-c,_
CONSTRUCTION INFORMATION:
Additional work to btkerformed under this permit—check all pa apply:
HVAC _Gas Tank nGas Piping IAA Shutters ElWindows/Doors
❑Electric ❑ Plumbing (Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sol. Ft. of First Floor:
o'
Cost of Construction:$ AV 0 0474
8 Utilities: _Sewer _Septic Building Height: •3O
OWNER/LESSEE: CONTRACTOR:
Name rltaeo,Afe+ Ili A ktes Name: I I p
Address: 723 ea PY1 54 . \0.y Company:do4S14 I 5L44 PYSJJ �. S; ti 44,--
City: es L State: FL— Address: d e?36 .$1. 2 dez, to pole.,
Zip Code: 3 t/9 8#G Fax: City: f T. el-€r4.. State: it-46._
Phone No. 3)3 - ga0 g'.S)7 Zip Code: .71/°J'y6 Fax: 79.2-40-- ,.sS
E-Mail: KA < Phone No. 7 7a - . q4)-4.4)(®.
Fill in fee simple Title Holder on next page(if different E-Mail: -A-do an • .S./nit b. < C a hoo . (C m
from the Owner listed above) State or County License: S e C 13//,..S. gbW/
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ,
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: y Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: phot 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 your N stice of Commencement.
/ 1
Sign'ure . •wner/Les /Contractor as Agent for Owner + gnature of Con vor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF \-_ L.occ' COUNTY OF 3k • \--A c- 4k
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledge before me
this\' day of q P-6\l ,2011 by this j3 day of a C\\ ,20\�, by
�i lr\� �s
�, kVb�1 c 1Indw. -s Sk0b; c
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Ident' 'cation Type of Identification
Produced L 4) L Produced ' D L
---
r,11FN5
(Signature of Notary Pub c-State of Florida) --,' (Signature of Not 'Pub-
ic-State-q; I "7: •• GG 022023
' GVV t;l ;41'1'''''''..:,,,,,'. my GOI �;o .ember 16.2020
Commission No.U dS� - Sera(1 NS ' t ;:' ��FtRES:D��� 1 naenmters
�'t.. s. �N#GG 022023 Commission No. ,,:':,, ':o. edTbrutlot2i(+
1 .F erlal"-- MY coK!f�1 `' be;16,2020
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REVIEWS FROM ION SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17