HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MMST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: V /> 1Y. Permit Number
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COUNTY
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mo Building Permit Application SEP 7 3 27,3
Planning and Development Services Permitting D,-,p;,.;rt.rnent
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Counzy, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re •• - ".
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:-
Address: 2801 BENT PINE DRIVE, FORT PIERCE, FL 34951
Legal Description: MONTE CARLO COUNTRY CLUB-UNIT TWO-LOT 91 (OR 4116-2116)
Property Tax ID#: 1334-502-0008-000-5 Lot No. 91
Site Plan Name: TANNER Block No.
Project Name: TAN NER
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
INSTALLATION OF(4)ACCORDION HURRICANE SHUTTERS
CONSTRUCTION INFORMATION ., . ' ,,„',,,:i, -, •„:.,. , , ., :: - ,,-„, --,, ,,, - ,,, ..:;,,v,„
Additional work to bg_p_erformed under this permit–check all that,apply:
IIHVAC ___Gas Tank nGas Piping IN/ Shutters flWindows/Doors
ElElectric D Plumbing n Sprinklers 0 Generator PI Roof Roof pitch
Total Sq. Ft of Construction: Sq±t,of First Floor:
Cost of Construction:$ 6,750.88 Utilities: I Sewer FISeptic Building Height:
OWNER/LESSEE: - --- , ,--, 1 ,:-tONTRACTOR:
Name JAIME E. TANNER Name: MIRIAM VAN TASSEL
Address: 2801 BENT PINE DRIVE 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. 772-321-6157 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:
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.
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Signature f Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA ) STATE OF FLORIDA 1
COUNTY OF '�- l—V�e l�St- COUNTY OF Si, `' Q
The forgoing instrumentdas acknowledged JQefore me The forgoing instrument was ack owledged before me
this ( day of err/` t`20/ by this > day of Sar f Win^ O /g:)y
/ f l r l ct rn i I a-g A N ��( f d irl s ) 1, a_.S.__-eJ
Name of person nja.king statement W�N Name of perso_ n,making statement
Personally Known Y OR Produced Identificatik Personally Known d/ OR Produced Identificatio
Type of Identification z c5 a Type of Identification
Produced --� Produced LL,;v
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• f Fc oa a LJ' m riffs.
1, iJ -ic AMM i ' 11(21-lbLe/ %` Jm. •-..1 Ji ii—117
(Signature o otary Public-State of' orida ) I� %m (Signature of Not '7 State of Florida'r I i "
Seal ���• m
Commission No. (Seal) _'_ -1;ti Commission No. (Seal)
:,roe,* -zo ea.411 rodo
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MA GROVE '
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE ..
COMPLETED
1 Rev. 8/2/17