HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p'/` /
Date: ZOI� Permit Number: ! 0y� (� S-b
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Building Permit Application
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
PROPOSED IMPROVEMENT LOCATION:
Address: 227 OLSON AVENUE, FORT PIERCE, FL 34946
Legal Description:
OLSON'S S/D W 1/2 LOT 16 AND ALL LOT 18 (OR 3408-2234-13944-34)
Property Tax ID#: 1433-502-0015-000-2 Lot No. 16/18
Site Plan Name: MOHAN Block No.
Project Name: MOHAN
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (12)ACCORDION HURRICANE SHUTTERS'^7yoS iL%1`d
CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit—check aMI/
appy:
aHVAC Gas Tank DGas Piping Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers M Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 5,328.88 Utilities:Sewer 0 Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name CALVIN MOHAN Name: MIRIAM VAN TASSEL
Address: 227 OLSON 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
Phone No. 772-577-1603 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 our Notice of Commencement.
Signature o Owner/Lessee/Contractor as Agent for Owner Sikriiafure o1 Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF l COUNTY OF
The for oing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
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Name of personJ�aking statement Na a of person making statement
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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( ignature of Notary Public- ate of Florida ) .11111,,, (Sign ture of Notary Public-Stat Florida)
Commission No. (Seal =
Commission No. (Seal) :
REVIEWS FRONT ' ZONING f PLANS VEGETATION SEA TURTLEM WZ mCOUNTER REVIEW IfWrn REVIEW REVIEW REVIEW � D
DATE �os�cn g3o $m
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Rev. 82/17
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