HomeMy WebLinkAboutBuilding Permit Application ALL APPLI BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Datery - 2q -,R'k � Permit Number:
Al
Building Permit Application ov X418
Planning and Development Services
y �
Building and Code Regulation Division Mty
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: 6301 SPRING LAKE TERRACE, FORT PIERCE, FL 34951
Legal Description: PORTOFINO SHORES-PHASE THREE- (PB 43-40) LOT 350 (OR 3928-2005 thru 2010)
Property Tax ID#: 1312-503-0123-000-3 Lot No. 350
Site Plan Name: CLAUDE Block No.
Project Name: CLAUDE
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF(14)ACCORDION SHUITTER SYSTEMS
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
HVAC F]Gas Tank E]Gas Piping Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers ❑Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: $ 6,958.00 Utilities: Sewer DSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name ALIX CLAUDE Name: MIRIAM VAN TASSEL
Address: 6301 SPRING LAKE TERRACE 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. 772-577-6631 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:
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 thepermit 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 of O ner/Lessee/Contractor as Agent for Owner Signature of C ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA �tt
COUNTY OF �� COUNTY OF T ' Q-
The forgoing instrument was acknowledgeoefore me The forgoing instru ent was acknowledgeefore me
this Z1 day of �� 2���'�, 20( by this�2 day of c(' 20 by
Name of person making statement Nam of person making statement
Personally Known r/ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State lorida) (Signature of Notary Public-State&TIorida
r�n� o, �
Commission No. (Seal) O �� cN Commission No. ( ^
7-1
d .- o.
N 0
Cc Q W N L c UL X eq X
�o
mR 'c �c m . �o 60 In
REVIEWS FRONT ZONING S is PLANS VEGETATION SEA TUR c ROuF4
COUNTER REVIEW &\jE 2 REVIEW REVIEW REVIEo Wry
DATEw m E>'` Q
RECEIVED u,m
DATE
COMPLETED Al
,,������•
Rev. 8/2/17