HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1' `) 1,(A Permit Number: \G 0 1 ---1 'COYR
REC'Eive0
.COONT"Y` ..
JAN 3 r 2019
Building Permit Application Permitting 0Q
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Planning and DevelopmentServices Lucie Coun yank
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: 40 Lagos del Norte
Legal Description: Spanish Lakes Country Club Village Leasehold Estates(OR 2389639)That Part of SEC As Shown
In Or 2389-639 Being Lot 40 Lagos del Norte(0.13 AC-5,663SF)(Or 3958-1159)
Property Tax ID#: 1301-500-0700-000-9 Lot No.40
Site Plan Name: Spanish Lakes Country Club Village Leasehold Estates Block No.
Project Name: Forrest
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION'OF WORK g,,
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Installing three accordion shutters to enclose the lanai area.
CONSTRUCTION INFORMATION
Additional work to be performed under this permit—check all 71.a.i apply:
n(HVAC Gas Tank ❑Gas Piping _Shutters In Windows/Doors
n Electric ❑
Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ v01)v vUUtilities:Sewer❑Septic Building Height:
OINNERJLESSEE CONTRACTOR
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Name Forrest Name: JeffJackman
Address:40 Lagos del Norte Company: Master Craft Aluminum Products
City: Ft Pierce State:_ Address: 1634 SE Niemeyer Cir
Zip Code: 34951 Fax: City: Port St Lucie State:Fl 'I
Phone No.401-231-2352 Zip Code: 34952 Fax: 772-335-0860 -i
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page(if different E-Mail: mastercraftaluminum@gmail.com
from the Owner listed above) State or County License: SCC131150586
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:P Name:Jeff•Ja6kmaP—
Address:4O Address: 4Ooie4 da
City: R•:1FCt State: City: Port£A-baete""---- State:
Zip: Phone Zip: Phone: 1
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
Name: Name: I
Address: yer Cir Address: I
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 your Notice of Commencement.
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Signur=o owner/L-ssee/Contractor as Agent for Owner gnatur,'• : e ractor/License Holder--
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TATE b F ' e • *A STATE OF FLORIDA
OIJN * •F st Lucie COUNTY OF St Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this lyZ day of ,20 /0 by this S 2)day of. �}4�-/, ,2011 by
0-P�F 0-ote,16i-r-., -5 POf.0 .5:0d2-7.--
Name
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Name of person making statement Name of person making statement
Personally Known L."- OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
MOW,salldx3 :1,,,,, OZOZ/SWI.saildX3 , st.
Commis '•4, !ko. SheMD• dd#W l..°''',�"'-° Commission No. n,�.,°�,,�,u��.n ° � 1�.=.;l:
` 7/4.2-,e,. NOTARYP ��t';1�:� O '.4..o',r
,�*r` 0 31V1.S VOILIOId AO 31V1S ;�,,. 'I
r STATED ° OIlBfld JltiV10N tet,``:,
�i „'. �, _Comfat FFt d ANION D ,
0 yaws Sheryl D.Mo&!9°? 'O&NS
REVIEjiISS �1' i}[PS_1/15 BONING SUPERVISOR Jim°t ,`�,; N� flAWU c SEA TURTLE MANGROVE
C�ORU�N�VTER! REVIEW REVIEW y,A , S1REEI6'�VFLORICA REVIEW REVIEW
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DATE t°.,�;. ° Comm#FF942382
RECEIVED , 1 Expires 1/15/2020
DATE
COMPLETED j
Rev.8/2/17
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