HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit
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Building Permit ApplicationLRE:
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11Planning and Development Services2019
Building and Code Regulation Division Department
2300 Virginia Avenue,Fort Pierce FL 34982 CQUntPhone: (772)462'1553 Fax: (772)462-1578 Commercial R yr FL
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 5208 Suson Ln
Legal Description: HOLIDAY PINES S/D-PHASE II-B-LOT 372(MAP 13/12S)(OR 394-398: 1668-1855:2636-2834:2661-586:4058-2026)
Property Tax ID#: 1312-801-0175-000-7 Lot No. 372
Site Plan Name: Block No.
Project Name: Hilary Hayes
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of 5 Accordion shutters
CONSTRUCTION_ INFORMATION:
Additional work to be nertormed under this permit—c ec a appy:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑.Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 3,159.76 Utilities:Sewer❑Septic Building Height:
OWNER/LESSEE: CONTRACT.O.R: ..:,_
Name Hayes, Hilary Name: RobertMcNally
Address: 5208 Suson'Ln Company: Palm.Coast'8hutters&Aluminum Products, Inc.
City: Fort Pierce -State: FL Address: 675-4th-St.-
Zip Code: 34951 Fax: City: Vero Beach State: FL
Phone No. -7 le -3-S36 Zip Code: 32962 Fax: 772-299-1958
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: CBC1262166
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: N/A 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 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 w rk or recording o r Notice of Commencement.
i
Signat re of Owne essee/Cont 'ctor Agent for Owner —Signature of Contract /Licen a older
STATE OF ORIDA STATE OF FLORIDA
COUNTY F // { COUNTY OF INDIAN RIVER COUNTY
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 17day of 201by this �2(�day of �/]�./ ,20 19 by
Hilalry Hayes ROBERT MC NALLY
Name of person making statement Name of person maki statement
Personally Known OR Produced Identification PersonKn x O P oduced Identification
Type of Identification Type o Iden 'fic
Produced L ,(�/a �/� Produce
(Signature o No (Signatur
Notary Public State of Florida ,�r P Notary Public State of Florida
Commission No. Giovanna Draesi) Commissio f� Giovanna Drausal [cea
Commission GG 287098 i/26/2 23 287086�
I Expires 01!28/2023 Expires 01128/2023
or
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17