HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: OCAV 64- Zo Permit Number:K 5=11.911111
RECEIVED
Building Permit Application
Planning and Development Services OCT 18 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 L ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED 1MRROVEMENT LOCATION
Address: 6643 NUEVO LAGO ST., FORT PIERCE, FL 34951
Legal Description: SPANISH LAKES FAIRWAYS BLK 41 LOT 7 (OR 4127-1976)
Property Tax ID#: 1306-500-0109-000-1 Lot No. 7
Site Plan Name: RIPLEY Block No. 41
Project Name: RIPLEY
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK a
INSTALLATION OF(5)ACCORDION SHUTTER SYSTEMS
a
CONSTRUCTION INFORMATION
Additional wor toe e orme under this permit—check a apply:
HVAC E]Gas Tank 0Gas Piping Shutters ❑Windows/Doors
0 Electric ❑ Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 13� Utilities: —Sewer Septic Building Height:
QV1/NER/LESS;EE CONTRACTOR
Name BENEJAH P RIPLEY III Name: MIRIAM VAN TASSEL
Address: 6643 NUEVO LAGOS 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. 518-744-7620 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.
SUPPLEMENTALCONSTRUCTION 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
commenc g work or recording our Notice of Commencement.
Signat re ol Owner/Lessee/Contractor as Agent for Owner Signature of C ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA '
COUNTY OF COUNTY OF
The for oing instrument was acknowledged efore me The for oing instrument was acknowledge before me
this�day of C�c b�� ,20� by this day of ��� ��+!,� .20L by
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Name of person making statement Name of person making statement
Personally Known_4,--" OR Produced Identification Personally Known zi' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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Commission No. Commission No.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17