HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i�
Date: 91
I 1 g 1\Ci Permit Number: 18 O-1-1 3 J
l-,-.s-,- ---:1 RECEIVED
Y
COUNT
F L_ CI R i.. D'. R SEP 1 8 2010
Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
-PROPOSED IMPROVEMENT LOCATION
Address: 6667 ALEMENDRA STREET, FORT PIERCE, FL 34951
Legal Description: SPANISH LAKES FAIRWAYS BLK 50 LOT 19 (OR 1888-344; 2372-1022)
Property Tax ID It: 1306-500-0167-000-5 Lot No. 19
Site Plan Name: BIERMAN Block No. 50
Project Name: BIERMAN
Setbacks Front Back: Right Side: Left Side:
DETAILED;DESCRIPTIONOF WORK.
INSTALLATION OF(6)ACCORDION HURRICANE SHUTTERS
CONSTRUCTION1INFORMATiON ,
Additional work to be performed under this permit-check all ;ha apply:
HVAC _Gas Tank Gas Piping ./ Shutters I I Windows/Doors
❑Electric ❑ Plumbing JSprinklers 0 Generator L I Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 4911.10 Utilities: _Sewer I n(Septic Building Height:
OWNER/LESSEE `i ' 'CONTRACTOR;.
Name JACK BIERMAN Name: MIRIAM VAN TASSEL
Address: 6667 ALEMENDRA STREET 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. 772-466-8734 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.
\T --)1
"it/varh. VAA...----cc1/47.'s—C\J
Signatur ofd Lessee/Contractor as A ent for Owner Signature of ontractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA f
COUNTY OF S+. 1_ COUNTY OF . -s.x-e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledge efore me
this l b day of 20 /8by this /8 day of �f lie,/,'2o )5. by
Z(I k a h a55eJ "V I {14 WI avl j 5e J
Name of personnking 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 is-State •...•PR�i ')0�023 (Signature of Notary ublic State of,., y
.,,r�pM GG 2 IE G►VENS
_ N 2020 NAMPR023Commission No. PlPU94c'••• •M� MEss�`' upt'ITV°de ,tees11— Commission Nv' � "; 161156,,MM1S e�cember�02o
„: V.P\R ry P 1' [r3`i `,11 EXPIRES.D p denvriters t
=r S %tz lb�Nata f'::.;:‘):41.1 t1hniNotary ublic��
F,;,1a tided Bonded _
REVIEWS .\E.v,p- A"' ZONING SUPERVISOR PLANS VEGE`T'ATION SEA TURTLE MANGROVE
UNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17