HomeMy WebLinkAboutBuilding Permit Application ALL.APPLICAI1BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: I��I g Permit Number:
- RECEIVED
Building Permit Application
Planning and Development Services AUG 21 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resl 8—en tial X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED 1MPROVEMENI LOCATION
Address: 9520 LAURELWOOD COURT, FORT PIERCE, FL 34951
Legal Description: MONTE CARLO COUNTRY CLUB-UNIT THREE- LOT 253 (OR 3979-247)
PropertyTax ID#: 1327-701-0073-000-1 Lot No. 253
Site Plan Name:ZHAO Block No.
Project Name: ZHAO
Setbacks Front X Back: X Right Side: X Left Side:
DETAILED DESCRIPTION OF WORK wf
41-
INSTALLATION OF(7)ACCORDION HURRICANE SHUTTERS.
CQNSTRUCTIQN I,NFORM'ATIO.N
Additional work toe e orme under this permit—check k a appy:
HVAC E]Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 4465.61 Utilities:cn Sewer Septic Building Height:
W-4 4$ ;CONTRACTOR. :
Name WE]ZHAO_ Name: MIRIAM VAN TASSEL
Address:9520 LAURELWOOD C OURT Company: DVT HURRICANE SHUTTERS INC.,
City: FORT PIERCE State:FL Address: 3100 N KINGS HWY
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No.407-864-9004 Zip Code: 34951 Fax: 770-794-1590
E-Mail: Phone No. 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail: dvthurricaneshuttersiric@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.
r
;Sl1PPLEMENTAL CONSTRUCTION LIEN:LZ1N IN.FORIUTATION
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
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.
Signature f Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
i
STATE OF FLORIDA ' STATE OF FLORIDA
COUNTYOF— C',lF, COUNTY OF
The for oing instr ent was acknowledge before me The forgoing instr en was acknowledge before me
this day of 20_W by this day of 120_A by
Name of per so aking statement Name of Pers n making statement
Personally Known �OR Produced Identification Personally Known J OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Not (Signa t re a e of Florida)
IIIIIIl,
`�o,�DsrP��'°� KAREN 5. IELSEN
=State REN S7-NN
t�S��A�Commission No. State of FIoF+I+ Rotary Public Commissio = rdtarCommission#GG 207hf24 0 ommission y PublicMy Commission
207.2Pires 0ii���� My CmmisunA In BxP�e84
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATUR NGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17