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HomeMy WebLinkAboutBuilding Permit Application SUAPLEMENTAL.CQNSTftUCTtON LIEN LAIN iNFQRM,4TIC�N� _ .MORTGAGECO PANY: ..,z, Note a a DESIGNER/ENG NEER: _Not Applicable Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITL9 HOLDER: _Not Applicable BONDING CODA ANY: Not Applicable Name: 1'�/,�2 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 thepermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or an 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 lend e or an attorney before commencingwork or recordingour Notice of Commencement. c Xlav Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contracto License Ider STATE OF FLORIDA STATE OF FLORIDA COUNTY OF -,E t4 D/,1-74 t; COUNTY OF -t:-tz DIS it,(JL� The forgoi i strument was ackn a before me The forgoing instrument was acknowledged before me this ay f i; 0/P by this day of 20_ by Name of person making statement Name of person making statement Personally Known OR Produced Identification y� Personally Known G OR Produced Identification Type of Identification Type of Identification Produced- -,cL .L Produc (Sign ure of No ary Public-State of Florida) (Signature of Notarf Public-State of Flo i Commission No. (Seal) Commission N cercu�nna Notary Public stateofFloridaa Draus � )mission FF 193077 0a 111P 'Notary Public State of Florida 0112612019 My Commission F 193077 RE F 0 �®i�bT12612o 9ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 ALL APPLICABLE/INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f� Date:_ (Y ' ��' �� Permit Number: U 0 '7 ................... Building Permit Applicatio R�E C Planning and Development Services JUN 15 2018 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 t n g D e p rtm e ntPhone: (772)462-1553 Fax: (772)462-1578 Commercial �A94Pt a+ xSUcte-Ee�+'�tY, FL PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRQPOSED tM1P VEMENT LOCATION s , ," "kart Address: '/� �� ►�C/// l Legal Description: RIVERPOINTE AT THE SANDS PHASE II (PB 43-16)LOT 55(OR 3029-618 Property Tax ID#: 1425-620-0048-000-0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE5CR[PTION OF WORK .. , :tR Installation of Hurricane Shutters a .e h n 01:� CONSTRUCTION INFORMATION Additional work to be nertormed under this permit—check all M apply: HVAC Gas Tank []Gas Piping Shutters Q Windows/Doors Electric Plumbing []Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ f? 4 -7 Utilities: _Sewer Septic Building Height: OWNER LESSEE _ < _ x . / , =. z CONTRACTOR Name ETC -/r/L%z L(� Name: _�©be� 1_�/ Address: 460 Gt/r I de,12 2 �Y Company: Palm Coast Shutters&Aluminum Products Inc " City: f-G:���jE--�� _� State: FL Address: (p TS SLAI '(- Zip Code: q4!3 /l/14- City: ✓r_-7L0 '_Jfe_Wk State:FL Phone No. /\/7al. Code: 32962 Fax: 772 299 1958 E-Mail: Phone No. 772 299 1955 Fill in fee simple Title Holder on next page(if different E-Mail: 9iovanna@palmcoastshutters.com from the Owner listed above) State or County License: Florida If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. V