HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED , r-�
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Building Permit Application J4N 02?,,
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Planning and Development Services mitt/q
Building
ode Regulation Division
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ePer
Virginia Avenue,Fort Pierce FL 34982 3t Cu a CDunty
2300@nt
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 6679 Tulipan
Legal Description: SPANISH LAKES FAIRWAYS BLK 55 LOT 9 (OR 4077-2233)
Property Tax ID#: 1306-500-0286-000-5 Lot No. 9
Site Plan Name: Block No. 55
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
6'— Installation of Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all hat apply:
Q HVAC Gas Tank (iGas Piping Shutters Windows
/Doors
I p g — Q
Q Electric Q Plumbing Sprinklers _Generator Q Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ 2,130.16 Utilities: _Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Velazquez, Carmen Name: ROBERT MCNALLY
Address: 6679 Tulipan Company: PALM COAST SHUTTERS&ALUMINUM PRODUCTS,INC
City: Fort Pierce State: FL Address: 675 4TH STREET
Zip Code: 34951 Fax: City: VERO BEACH State: FL
Phone No. Zip Code: 32962 Fax: 772-299-1958 1
E-Mail: Phone No. 772-299-1955
Fill in fee simple Title Holder on next page(if different E-Mail: GIOVANNA@PALMCOASTSHUTTERS.COM
from the Owner listed above) State or County License: CBC 1262166
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: j
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. I
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.
ect...4,1-7,,,. r.-1/Lic.„4,, . At f)• ,_,/,/
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Signature of Owner/Lessee/Contractor a�s'Agent for Owner Signature o xi ' -• -4.. .-
STATE OF FLORIDA , STATE OF FLORIDA
COUNTY OF ii) di-0 vi--"p,)0Y COUNTY OF INDIAN RIVE' OUNTY
The forgoing instrument was acknowledged before me The for oing instr nt was a nowledged before me
this 1 ; day of '.' c ,20]J by this 1 g day of R_C. ,20 16 by
Carmen Velazquez ROBERT MC NALLY
Name of person making statement Na to of person mak' :statement
Personally Known OR Produced Identification )( Personal K ow X 0, •roduced Identification
Type of Identification Type of de ifica .,.
P duced 4- Dc.. C x-p /0/0,7/901 Pro uce. _�. „ism/
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C igna ertiti2dbff -. . - -.. (Signat : 7'?174 4 :.,;• , . ..4 .. I
o s,Pk. Notary Public State of Florida o 3 RV® Notary Public State of Florida
Commission •.a ° Giovanna Drausaksealj Commi .i co: Giovanna Dra_uFsal Se.
c` My GunmAssion FF 119307 g M�Co �nis.kq F 193077 •
oFII, Expires 01/26/2019 isrTAS Expires 01/26/2019
REVIEWS FRONT ,ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER , REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED '
DATE
COMPLETED
Rev.8/2/17
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