HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date: S 2� Permit Number:AAS
RECEIVED
s
Building Permit ApplicationSEP 0 5 2018
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
SEP
PERMIT APPLICATION FOR: Shutter
;PROPOSED IMPROVEMENT LOCATION
Address: 7103 PACIFIC AVENUE, FORT PIERCE, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 11- BLK 147 LOT 22 (MAP 13/12N) (OR 819-366)
Property Tax ID#: 1301-613-0237-000-9 Lot No. 22
Site Plan Name: WALKER Block No. 147
Project Name: WALKER
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK' n
Y
INSTALLATION OF: ,- / .CCORDION HURRICANE SHUTTERS
'JN,ORNlATION
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Additional work to be nertormed under this permit—check ail appy:
HVAC Gas Tank Das Piping Shutters Windows/Doors
11 Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4825.10 Utilities:Sewer Septic Building Height:
OWNER%LESSEE CONTRACTOR
Name DIANE WALKER Name: MIRIAM VAN TASSEL
Address: 7103 PACIFIC AVENUE 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. 772-240-9745 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.
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SUPPLEMENTAL CONSTRUCTfiON LIEN LAW INFCiRMATION
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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.
Signat a of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA ISTATE OF FLORIDA
COUNTY OF JA LI-CAPJ COUNTY OF -�
The for i instrument was acknowled ed efore me The fo(�g�oinJJg instrument yeas acknowledge before me
this day of ��ke vv��je f 20 lby this Say of / ��^��0 by
1" \;�,Ci C,-wL Vice >e� 1MYNI
Name of pers making statement Name of person making statement
Personally Known OR Produced Identification Personally Known •>/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Pu Iic-State of Florida (Signature of Notary P blic-State of Flori
GNE14S `. IE GIVENS
S� RIE 0�2p73 #GG 022023
Commission No.X y� coM�IONT 16 2020tec>1'` Commission No _ MYCa 16 2020
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REVIEWS FRO ING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17