HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED &V
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Building Permit Application JUL 2 3 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
PR'OPOSED,.IMP.ROVEMENT LOCATION:
Address: 2209 DADE ROAD, FORT PIERCE, FL 34982
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al gescription: fy Lt Df 5W -1/u0F Sw !/I L19o•_S iF 60irpoe,-r 00 10 7- 619// wiM Nlgof
5s Y of Sw Tz /� / ,t2.E Sw
p y 2428-331-0001-0 0-5 �9 SS- y� 2 3�'t°
Pro ort Tax ID#: Lot No.
Site Plan Name: CHARLES R BREEN Block No.
Project Name: CHARLES R BREEN
Setbacks Front Back: Right Side: Left Side:
D'ET�AyILED DESCRIPTION-OF`WORK:
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INSTALLATION OF THIRTEEN(13)HURRICANE SHUTTERS
PCONSTRUCTION•IN`FORMATION:
Additionalwork -oe e orme under this permit—check a appy:
❑HVAC Ei Gas Tank []Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 5529.40 UtilitieslnSewer❑Septic Building Height:
01NNER/LESSEE CONTRACTOR:-.
Name RICHARD R BREEN Name: MIRIAM VAN TASEL
Address: 2209 DADE ROAD Company: DVT HURRICANE SHUTTERS INC
City: FORT PIERCE State: FL Address: 3100 N KINGS HIGHWAY
Zip Code: 34982 Fax: City: FORT PIERCE State: FL
Phone No. 772-468-1093 Zip Code: 34951 Fax: 772-794-1590
E-Mail: whatagrind@bellsouth.net 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.
Usaw
P EMENTAxL CONSTRUCTIO�Ntol[EN.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 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
KING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice fol l.....
b rovements to your property.A Notice of Commencement must be recorded and posted on the jobsi
A • •; re the first inspection. If you intend to obtain financing, consult with lender or an attorney before •�;,;;,,,.•
mencin work or recording our Notice of Commencement.
m
afure f Owner/Lessee/Contractor as Agent for Ownergnature of Contractor/11cense Holde
c TE OF FLORIDA L ) �� STATE F FLORIDA _"T
NTY OF "j L 1 (� COUNTY OF a C- z 8:�!
a Th forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
day of ,+ 20]by this day of II 20_W by )
a ncl V Ct n��s S�� M % r i a i r ) �n a s Se 1
Name of person king statement Name of pepking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of N ry Public-State of Florid (Signature of Not6K Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17