HomeMy WebLinkAboutBuilding Permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�y
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Date: \tic;ti �7 K, Permit Number: � ' r `� `
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
j PROPOSED IMPROVEMENT LOCATION: j
Address: 2703 BENT PINE DRIVE, FORT PIERCE, FL 349851
Legal Description: MONTE CARLO COUNTRY CLUB-UNIT TWO- LOT 97
Property Tax ID#: 1334-502-0014-000-1 Lot No. 97
Site Plan Name: VEIT Block No.
Project Name: VEIT
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (4)ACCORDION SHUTTER SYSTEMS
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit—check all appy:
HVAC Gas Tank DGas Piping Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: $ 2,360.06 Utilities:Sewer Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name HENRY VEIT Name: MIRIAM VAN TASSEL
Address: 2703 BENT PINE 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. 315-247-2149 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: 3100 N KINGS HWY 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 0 Owner/Lessee/Contractor as Agent for Owner Signature of C ntractor/License Holder
STATE OF FLORIDA ! � � STATE COUNTOY OF FLORIDA
COUNTY OF
The forgoing instru ent was acknowledged before me The forgoing instruGnent wa acknowledged before me
this�day of by thisZ:L day of 20leby
Name of person making statement Name of person making statement
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Si nature of Notary Public- ate of Florida ) (Signature of Notary Public-Stat/of Florida )
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Commission No. (Seal) 0
mmission No. (Seal) o z^ y
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DATE =LL t0 G D Q o E ci
RECEIVED r o.E w w m E �
DATE _cD o
COMPLETED \
Rev. 8/2/17
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