HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9. 1g/F- Permit Numb: /(57199- 1094 &
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FLORID "
Building Permit Application SEP : 3 202
Planning and Development Services
Building and Code Regulation Division Perm ittino 1:".7:'F%3 rl-rr./..,- t
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2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie rounty„ FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial ..
PERMIT APPLICATION FOR: Shutter
„PROPOSED IMPROVEMENT LOCATION:
Address: 4700 JUANITA AVENUE, FORT PIERCE, FL 34946
Legal Description: HARMONY HEIGHTS ADDN BLK J LOTS 5,6 AND 7 (OR 316-2769: 554-2769: 554-2957
Property Tax ID#: 1431-701-0153-000-6 Lot No. 5,6,7
Site Plan Name: INGRAM Block No. J
Project Name: INGRAM
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
INSTALLATION OF(9)ACCORDION HURRICANE SHUTTERS
CONSTRUCTION INTORKATION:
Additional work to IIbe,performed under this permit–check all-,hati apply:'
I —Gas Tank HVAC flGas Piping 1'Shutters n Windows/Doors
ElElectric 0 Plumbing Sprinklers [iGenerator 7 Roof Roof pitch
Total Sq. Ft of Construction: S9. Ft.of First Floor:
Cost of Construction:$ 6,529.02 Utilities: I Sewer 7 Septic Building Height:
OWNER/LESSEE: - : 1... -, ' ., . ..',CONTRACTOR:
Name DELORES INGRAM Name: MIRIAM VAN TASSEL
Address: 4700 JUANITA AVENUE Company: DVT HURRICANE SHUTTERS INC.
City: FORT PIERCE State: FL Address: 3100 N KINGS HWY
Zip Code: 34946 Fax: City: FORT PIERCE State: FL I
Phone No. 772-461-6946 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 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 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 your Notice of Commencement.
a x-IL. - 'Waal. 5—) - — f e"--7-1 ISignature if Owner/Lessee/Contractor as Agen 4 or pwn Signature of ontractor/License Holder }}rF2
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STATE OF FLORIDA C Q aLLr a STATE OF FLORIDA } ' =,,..c6=
COUNTY OF �- • Z =z a COUNTY OF St L L9_ mz
The forgoing instrument s acknowledged efo - cc 2 - The for oing instrume t was acknowledged befor: nyl�
this f ��day of ,\��� 2by >w g this day of 2`t �- ,2t)�Ig by a
V(�l Ci yin Veen J Q 5.�4:i �,,„,m I/I retia_ 1-I Vail J . / m
N• - if person making statement ;: f',,j"•a= Name . •erson making statement 0.1.:.
Personal, Know OR Produced Identific:: .•----1 , Personall own OR Produced Identifica : •�� 3/a
Type of I: i ' • .tion : """`%,t;,at Type of Ide' ation `-;;,":„ %•..-:
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Produced Produced _
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(Signature otary Public-State of Fulda) l./ (Signature of Notarblic-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17