HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ‘\c‘Nr. S\2r.)1 Permit Number: i % ti"'" 00 56
.fimes.1111111.11m1111 1
COUNTY
FLORIDA
11111111111.11MINUM. 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: 4245 S INDIAN RIVER DRIVE, FORT PIERCE, FL 34982
i
Legal Description: PLEASE SEE ATTACHED
Property Tax ID#: 2435-113-0007-000-8 Lot No.
Site Plan Name: BLOEHM Block No.
Project Name: BLOEHM
Setbacks Front Back: Right Side: Left Side:
IbEYAT(E0:0 ikkip.-rioNi:bFWORK....--. --: if' ' -: --:.-:- ---' ':''',,,-- : . -,•- --: -,--, , -- 2-; -:- ' -:-.,--- i,:;.:...,,
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INSTALLATION OF(7)ACCORDION SHUTTER SYSTEMS
C04STROOIONLINF:ORMATION:"' ..--:,,,..---. ,' :- -•,-; ---,-;,-- -,-,•:, ,,,:- - A-;:":.:,. • , -•.-: ;.,',:''-:: r':- - ', -:,:"'z:,,,•-• . ::. :- .:::',';::.:::-.,,
Additional work to bp_grformed under this permit—check all-,ha apply: — —
11HVACGas Tank Gas Piping "I Shutters Windows/Doors
—
lElectric r—i
El Plumbing n Sprinklers Li Generator r7 Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 2,287.49 Utilities: Sewer pi Septic Building Height:
'-'OWNER/LESSEE::.- -- - ' '--. : -' - ''''. ---• ' - : ::,CONTRACrOk:
Name ROSALIE BLOEHMName: MIRIAM VAN TASSEL
Address: 4245 S INDIAN RIVER DRIVE Company: DVT HURRICANE SHUTTERS, INC.
FORT PIERCE 3100 N KINGS HVVY
City: State: FL Address:
Zip Code: 34982 Fax: FORT PIERCE State.
' FL
City: . ,
______
Phone No. 772-461-1656 Zip Code: 34951 Fax: 772-794-11590
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. i
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UPPLEMENTAL CONSTRUCTION •
LIEN LAW'INFORMATION:'
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable.
Name: Name:
Address: Address:
City: State: City: State: I
Zip: Phone . Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address: . -
City: City: .
Zip: Phone: Zip: Phone:
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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. I
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 1
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 i
commencing work or recording your NoticeNof Commencement.
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Signature o Owner Lessee Contractor as Agent for Owner Signatur of Contractor/License Holder
g / / g g
STATE OF FLORIDA STATE OF FLORIDA '
COUNTY OF S�• �0-e�sZ, COUNTY OF A . �v-e_.iJ,
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me ,
this day of ��J e wA-�20%is by this .S day of OJI p‘ ��,20 I g by
\�‘Qh/t V�N�c�1V\ �\rkCAI..A \I& c„�Sk,
Name of person making statement Name of person making statement
Personally Known OR Produced Identification bL Personally Known OR Produced Identification C TX-
Type
i LType of Identification Type of Identification
Produced F'( -`DL Produced FLA)I_
die
A J it . . �
(Signature of Notary P'.LL o.a{moi^r'�) (Signature of Nota el 1�au,Sl ?of Florida]
���� ii4,, ELLEN VAUGHN ;o�PaV" ELLEN
Commission No. _; Bo,State of di)ida-Notary Public Commission No. /"i ' State of Flori Lary Public
"111 - Commission #GG 270079 ;y'11;�� Commission # GG 270079'
,i P°�' %'fr "c•P My Commission Expires,��`�i My Commission Expires o,,p ie• p 1
• �� October 22, 2022 Oct
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I
RECEIVED
DATE
COMPLETED _
Rev.8/2/17
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