HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �ct
Date: )� Permit Number: 1J rz�d�O3
RECEIVED
Building Permit Application
Planning and Development Services SEP ®5 2018
Building and Code Regulation Division ST, Luclo Count
2300 Virginia Avenue,Fort Pierce FL 34982 Y� Porrnlel ink
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Shutter
PRQPOSED-,IIViOVEMENT+LOCATIQN ..
Address: 3616 GROVE COURT, FORT PIERCE, FL 34951
Legal Description: THE GROVE AT PANTHER WOODS (PB 40-5) LOT 10 (OR 1425-2528)
Property Tax ID#: 1327-805-0006-000-0 Lot No. 10
Site Plan Name: VINCENT Block No.
Project Name: VINCENT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIO`r OF WORK
INSTALLATION OF(10)ACCORDION HURRICANE SHUTTER SYSTEMS.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all tb.at appy:
HVAC Gas Tank ❑Gas Piping ✓ Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers OGenerator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ l0 77 Utilities:[]Sewer OSeptic Building Height:
OWNER/LESS.EE f`: ` . w CONTRACTOR:
Name RONALD VINCENT Name: MIRIAM VAN TASSEL
Address: 3616 GROVE COURT 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. 772-465-5218 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@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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION x
e
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Add ress: 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 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 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 of Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF s4 COUNTY OF
The foo oing instrument was acknowledged before me Theforgoing instrument was acknowledged before me
this day of SP-R-Ay 201' by this 5 day of a 3' 2014 by
J -ev �
Name of person making statement Name of p�rson making statement
Personally Known J OR Produced Identification Personally Known OR Produced Identification
Type of Identification ! Type of Identification
Produced Produced
(Signature of Notary Pub'c-State of Florida) (Signature ofr,ti
DBANMMARIr:
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REVIEWS FRO SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUN REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17