HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: !)Z$ / Permit Number: r R'DPI - (0 5
COUNTY.
,F ,L O R. '1 b' ,A' -
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 T_ f _ ' ., ..
Address: 2481 S JENKINS ROAD, FORT PIERCE, FL 34947
Legal Description: 24 35 39 S 1/2 OF N 1/2 OF SE 1/4 OF NE 1/4- LESS W 1000 FT AND LESS E 40 FT AND
LESS N 150 FT AND LESS S 60 FT- (0.87 AC) (OR 282-1253: 808-7)
Property Tax ID#: 2324-141-0006-000-7 Lot No.
Site Plan Name: STEPHENS Block No.
Project Name: STEPHENS
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION 'OF WORK
INSTALLATION OF(2)ACCORDION SHUTTER SYSTEMS
CONSTRU(T):01\11 NFORMATION
Additional work to be erformed under this permit—check all ;ha;apply:
HVAC II Gas Tank } Gas Piping �_Shutters l l Windows/Doors
SElectric ❑Plumbing Sprinklers 0 Generator I I Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1,278.99 Utilities: n
_Sewer[ (Septic Building Height:
OWNER/LESSEE : CONTRACTOR:
Name CLARENCE B STEPHENS Name: MIRIAM VAN TASSEL
Address: 2481 S JENKINS ROAD Company: DVT HURRICANE SHUTTERS INC
City: FORT PIERCE State: FL Address: 3100 N KINGS HWY
Zip Code: 34947 Fax: City: FORT PIERCE State: FL
Phone No. 772-370-1685 Zip Code: 34951Fax: 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 pplicable Home Owners Assocition 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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1 Signature of wner/Lessee/Contractor as Agent for Owner Signature of C ntractor/License Holder
STATE OF FLORIDA ( . J �rN 4TATE OF COUNTY OFORIDA 5 .L I
COUNTY OF TJ N
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The forgoing instrument as a knowledged efore m: a± he forgoing instrumen was acknowledged efore'I f�"
this zg dayof re11 {' �,20 S b R 6 day rby o a
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Name of person making statement ` a 0x- Name of person making statement 'I ¢0w g
Personally Known L.,---OR Produced Identificatio m"� m -'ersonally Known OR Produced Identificat.in
Type of Identification ype of Identification ;