HomeMy WebLinkAboutBUILDING PERMIT (2) i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -LD I P I rmit Number: n�O ` (0 1-1
Building Permit App ication
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
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PERMIT APPLICATION FOR: To Select from dropbox, click 1,1arrow at the end of line
PROPQSE<D I(VIPRQVEMENT LOCATION '',
Address: 6633 PICANr�TE CIRCLE, FORT PIERCE, FL 34951
Legal Description: erlw/ /
Lf'>-r & La /
Property Tax ID#: Lot No.
Site Plan Name:THOMAS PORTER Block No.
Project Name: THOMAS PORTER
Setbacks Front Back: Right Side: Left Side:
�DETAtLEDzDESCRIPTION OF WORK : ' � � � � � '
INSTALLATION OF HURRICANE SHUTTERS-ONE(1)OPENING/ACCORDIO
CQNSTRUCTIOI� INfORNI`ATION `
A clitional work to be nerformeci under this permit-check�all appy:
HVAC Gas Tank DGas Piping _Sl-hitters Windows/Doors
11 ❑
Electric ❑Plumbing Sprinklers Gnerator ❑ Roof Roof pitch
Total Sq.Ft of Construction: S Ft.of First Floor:
j Cost of Construction:$ ��/. 7 Utilities. Sevier Septic Building Height:
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OWNER/LESSEE { : .. CONI"R' CTOR
NameTHOMAS PORTER Name: MIRIAM VAN TASSEL
Address:6633 PICANTE CIRCLE Compan�- DVT HURRICANE SHUTTERS, INC.
City: FORT PIERCE State:FL Address: 3100 N KINGS HIGHWAY
Zip Code: 34951 Fax:- City: FORT PIERCE State:FL
Phone No.772-579-2615 Zip Code 34951 Fax: 772-794-1590
E-Mail:tporter942@comcast.net Phone N? . 772-466-4575
Fill in fee simple Title Holder on next page(if different E-Mail: dvthurricaneshuftersinc@hotmail.com
from the Owner listed above) State or i ounty License: 24394
If value of construction is$2500 or more,a RECORDED Notice of Commence Tient is required.
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ya` C N TRUCTI®N LI' N"IAWINFORIVIATI
S:UPRLEM�NTAL O,
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DESIGNER/ENGINEER: _Not Applicable MORTGATE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: I Phone:
FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City: I
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtair1l 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 Counter makes no representation that is granting a permit will authori a 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 th t I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.LuciI 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 alccessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commend ment 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, cons It with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signa ure of Owner/Lessee/Contractor as Agent for Owner Sig t re o Contractor/License Holder
STATE OF FLORIDA STATE OI FLORIDA c ` 1
COUNTY OFCOUNTY OF �r-hsuxAs�
jThe forgoing in trument was acknowledged before me The f goi g instrum t was acknowledged before me
thisci day o 1 f 20�11 by this I day of 20,�L by
�� V C ZG o eQ C7L�.
Name of person making statement ame of person making statement
Personally Known OR Produced Identification Personally Know OR Produced Identification
Type of Identification Type of Id ntification
Produced Produced
LASHAHiNA INGRAM
,O�Pav Ppe(�� `Uuupi
� vLASHAHNAINGRAM
a u Notary Public-State of Flori la v
N� n�e
Notary Public-State of Florida j
4•e MY Gomm.Fxni P.`npr9 9t 1 -
P' - i m un. cxpue5 u�c u,t }
(Signature of Notary Pub' - F� ori&)nmission#FF 177299 ( lgnatur of Notary Pub}4 t Fl�ri a
y. `F3 �o.1miss,on #FF 177249
Bonded through National Notary As•n, qF °•`
Commission No. e Bonde�Seal
��}' vCommissi n No. ) -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
i RECEIVED
DATE
COMPLETED
Rev.8/2/17