HomeMy WebLinkAboutSTORM SHUTTER ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� �� Permit Number: 1�d�J �31a
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Building Permit ApplicationPermitting
Planning and Development Services ..
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
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Address: 10307 S Indian River Drive
Legal Description: HEERMAN'S S'D THAT PART OF LOT 2LYING E OF REC RR RNV-LESS N 99.13 FT AS MEASURED ON RR(OR 3791-963)
Property Tax ID#: 3529-701-0004-000-3 Lot No.
Site Plan Name: Block No.
Project Name: JESSE AND KIM PHILLIPS
Setbacks Front x Back: Right Side: Left Side:
Installation of one roll-up at the guess house.
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Additional work to be ertormed under this permit—cneCK all appy:
❑HVAC Gas Tank ❑Gas Piping Shutters a Windows/Doors
11 Electric 0 Plumbing OSprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
3.5 }'f Utilities.Sewer Septic Building Height: 20 ft.
Cost of Construction:$ � ,
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NameJesse E Phillips and Kim M Phillips Name: Edwing Sosa
Address:10307 S Indian River Drive Company: Edwing's Unlimited Shutter Services, LLC.
City: Fort Pierce State:FL. Address: PO Box 881085
Zip Code: 34982 Fax: City: Port St. Lucie State:FL.
Phone No. Zip Code: 34988 Fax: (772)905-9431
E-Mail: Phone No. (772)370-0766
Fill in fee simple Title Holder on next page(if different E-Mail: ed@edsunlimitedservices.com
from the Owner listed above) State or County License: 28457
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: X 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 our Notice of Commencement.
L-A va i OSS l�L�
Signature of 0 ner/Lessee/Contractor as Agent for Owner Signature of Con ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF `�.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 16 day of V-N.: 20%by this '7-> day of 20 )"Cby
Name erson making statement Name offrson making statement
Personally Known OR Produced Identification L/ Personally Known OR Produced Identification✓
Type of Identification Type of Identification
Produced ProUucdZ
NA MARCELA ALARCON
_'(Signa re f otary Public- tat e�s'o��{QridaANAMARCELAALARCON gn ure otary Pu iE° FIgQ `�yblk-5tateo Fioa
Notary Public-State of Florida •: Comm scion A GG 135318
• ,;; My Co res Aug 16,2021
Commission No. ' P_s'($,e�i'Pmission#GG135318 Commission No. .'�=_= gMd� ponalktaryAssn.
moo,: y Comm.Expires Aug 16,2021
Bonded through National NotaryAssn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17