HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED p
Date: 1 k—S— l S Permit Number: 10 i i QO
dIIrc., .:::r1-.5-1;:._ _,, RECEIVED
COUNTY
F L. 0 R. I. 0 R NOV O� 1O1B
111111111 Building Permit Application
Planning and Development Services Permitting Department
County
Building and Code Regulation Division St.
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT`LOCATI.ON: = _
Address: 5726 PLACE LAKE DRIVE, FORT PIERCE, FL 34951
Legal Description: PORTOFINO SHORES-PHASE THREE- (PB 43-40) LOT 56 (OR 3465-1813)
Property Tax ID#: 1312-503-0012-000-2 Lot No. 56
Site Plan Name: PATRY Block No.
Project Name: PATRY
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF_WORK w
INSTALLATION OF(18)ACCORDION SHUTTER SYSTEMS
CONSTRUCTION INIFORNIATION
Additional work to be performed under this permit—check all apply:
El HVAC Gas Tank Gas Piping i" I Shutters Windows/Doors
p g
0Electric 0 Plumbing JSprinklers 0 Generator 1-1 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 10,568.28 _ Utilities: n
_Sewer( ISeptic Building Height:
i
OWNER/LESSEE: '''''',--= -= CONTRACTOR:
Name DANIEL PATRY Name: MIRIAM VAN TASSEL
Address: 5726 POLACE LAKE DRIVE 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. 514-654-6294 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: rI
I I
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: I -
Address: Address: it
City: City:
Zip: Phone: Zip: Phone: ,!
'I
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. i
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 prohibitlsuch
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 ) yr_.P,9.�J Siz„._..--_-___--s-.-----c.,-.„7_74.9\
Signature oTOwner/Lessee/Contractor as Agent for Owner Signature f Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA Lv--uQ
COUNTY OF S�T. ISZ COUNTY OF
The forgoing instrurrTnt was acknowledged efore me The fo jgoing instrycnent was acknowledgeeefore me
this 5 day of J 2
- c A,,Ar.,- 20 i by this day of 0�:>Jk��,20 1 by
WV(1\cxv .\ \i'Gu\_ \ c.:„ J V�\fiAo,w— �c \ i
Name of person making statement Name of person making statement
Personally Known OR Produced Identification DL Personally Known OR Produced Identification F)-1).L
Type of Identific-tion Type of Identificattpr Di____FI L- Produced 66
(Signature of Notary !T-7---:----,• :-.........,- . (Signature of Notary ••-.:..,�.,: - .• ••-
g e i b t A,Y ' ;' . Eei)Ajja-L
"AYo''' ELLEN VAUGHN
�o'o ���w+YPU i ELLEN VLAUGHN
;State of,Fi a-Nota? Public Commission No. ;�2��;\1�_State of FI ?votary Public
Commission No. *= Comm�ssion�#GG 270079 :y., ,.�;
ommission #GG 270079
',7,411,10$. ''E . o.A. My Commission Expires
My Commission Expires '� or�� .
October 22, 2022 """�� October 22, 20221
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17