HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: W Permit Number:
_.__ _.,�Ve� -Y FAUG
EIVED
Building Permit Application2 8 2018
Planning and Development Services . unty, Permitting
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
PROPOSED IMPROVEMENT LOCATION:
Address: 7006 Sebastian Road, Ft. Pierce, FL 34951
Legal Description: Lakewood Park- Unit 11- Ellk. 150 Lot 8 (Map 13/12N ) ( Or 3367-889 )
Property Tax ID#: 1301-613-0307-000-1 Lot No. 8
Site Plan Name: Rolle Block No. 150
Project Name: Rolle
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONOF WORK:
INSTALLATION OF ELEVEN ( 11 )ACCORDION SHUTTERS AND ONE( 1 )OPENING WITH ALUMINUM PANELS.
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—c ec a appy:
HVAC Ei Gas Tank DGas Piping Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 5101.00 Utilities:Sewer OSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Tillman Y Rolle Name: Miriam Van Tassel
Address: 7006 Sebastian Rd. Company: D.V.T. Hurricane Shutters, Inc.
City: Ft. Pierce State: FL Address: 3100 N Kings Hwy.
Zip Code: 34951 Fax: City: Ft. Pierce State: FL
Phone No. Zip Code: 34951 Fax: 772-794-1590
E-Mail: Phone No. 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail: dvthurricaneshuttersinc@hotmaii.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.
SUPPLEMENTAL CONSTRUCTION LIEN 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
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.
vCh
Signature tf Owner/Lessee/Contractor as Agent for Owner Signature of ,ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 4- (-J
The forgoing instr ent was acknowledg before me The for oing instrum nt was acknowledge efore me
this day of 20 by this=day of 20jby
I rJa VIA
Name o i per o a statement Name of perso making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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I .
I ,
(Signature of Notary Pu lic- tate of Florida) (Si nature
`,�"yp&/�� KAREN S. NIELSt=N
Commission No. �,��""���, KARE S$al IIELSEN o°�` ��.State of Florida-Nor P blic
Commission >. _ ion # G 1 64
o tate of Florida-Notary Public .:
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*E Commission # GG 207484 =",, Q�`tr My Commission Expires
on Expires Conmissi
� June 122022
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REVIEWS TOm ffING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17