HomeMy WebLinkAboutBuilding Permit Application I
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater- a'a. A Permit Number: dro-G 3d
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Building Permit Applic tion
Planning and Development Services ST. Lucie Courmitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
PRbPOSED im-P VVEMENT'LOCATION.
Address: 6687 Dickinson Ter., Port St Lucie, FL 34952
Legal Description: OLEANDER PINES REPLAT BLK 1 LOT 161 (0.265 AC) (OR 3076-1391; 3204-357)
Property Tax ID#: 3415-706-0032-000-3 Lot No.161
Site Plan Name: Block No. 1
Project Name: Cipriano shutters
Setbacks FrontX Back: Right Side: Left Side:
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DETAILED DES?CRIPTION OF WORK,
2 accordion shutters (front door and the top garage window)
CONSTRUCTION INFORMATION Y
Additional work to be nertormed under t ispermit—checall tdat appy:
HVAC Gas Tank ❑Gas Piping Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 717.00 Utilities: Sewer Septic Building Height: 20 ft.
.OWNER/LESSEE:' :u ,CONTRACTOR:. ,
NameJoseph J Cipriano Name: Edwing O. Sosa
Address:6687 Dickinson Ter. Company: Edwing's Unlimited Shutter Services, LLC.
City: Port St Lucie, State-FL. Address: PO Box 881085
Zip Code: 34952 Fax: City: Port St. Lucie State:FL.
Phone No.(571)274-0436 Zip Code: 34988 Fax: (772)905-9431
E-Mail: Phone No. (772)370-0766
Fill in fee simple Title Holder on next page(if different E-Mail: ed@edsunlimitedservices.com
from the Owner listed above) State or County License: 28457
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip' Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x 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 thepermit 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.
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Signature of Ow er/ ssee/Contractor a Agent for Owner Signature of Contra f
for/License Holder
STATE OF FLO DSA STATE OF FLORIDA
COUNTY OF I• L u k 3 COUNTY OF !�� . c-%-f
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1 day of P1 u ,20(8 by this \%day of CE'l-" ,201oCby
�n S�P Cc r'r a h o F cS tiara S c, �-
Name of p rson making statement / Name of pbAon making statement
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Ide tifiction Type of Identification
Produced Produced
QCV.—CA , BLANCA L.90SA`
(Signature of Not fi c ��i3 0 i� IC•'8118111 of Florida. ign ur o Notary P c- t t of Florida)
•- Commie Ion 0 FF 9529A2
r i �pi''•., ANA M ELARCON
F I ,?: My Com Ire9 May 29,2020 COMMIssiOn No. __°. '��= ry q�[- :ILAN
aCommission No. o AnndedWoough IonplNolaryAssn. Nota Pulte gCommission N G�,- �,oP= My Comm.Expires 1
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17