HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: D2 �1 J– 20 15 Permit Number: / v� 10� 1io
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- Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St, LucieQU my, �L
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial i4esidentia
PERMIT TYPE: H urr,Cw-'r—
iPR®P05ED"INPR®1/EMENT LOCATION.:
Address: 7501 Pensacola RD Fort Pierce, FL 34951
Property Tax ID#: 1301-606-0221-000-2 Lot No.Lots 22 &23
Site Plan Name: Christie R Lewis Block No. 67A
Project Name: Christie R Lewis
D:E�TLED ®�E�SCRIP�Tg-I,O,�N�QrFW�ORK ' '�
Installation Of Eleven (11)Accordion Hurricane Shutters And One (1) Lexan Hurricane shutters
ONSi CgTION NFORMATION
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 5,193.72 Utilities: —Sewer —Septic Building Height:
®WAIVER/LESSEE � a,,. ; CONTRACTOR �;
Name Christie R Lewis Name:Miriam}Van Tassel
Address:7501 Pensacola RD Company:DVT Hurricane Shutters Inc.
City: Fort Pierce State: j�• Address:3100 N Kings Hwy.
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-979-0934 Zip Code: 34951 Fax: 772-794-1590
E-Mail:Christie-7501 @yahoo.com 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 License24394
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL. C®NSTRl11NLIEN�LAUVaINFORMATIOIV
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 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.
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Signat a of Owner/Lessee/Contractor as Agent for' + , Signature f Contractor/License Holder z
STATE OF FLORIDA Z STATE F FLORIDA W�U
COUNTY OF �.. _ COUNTY OF �- c'�—
The forgoing instrument was acknowledged before m s 3X The forgoing instrument was acknowledged befor me w
this L day of u`c rV' 20��by �1�" this lS day of lea�✓as ren ,20��by
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Name of person making statement. ame of person making statement.
Personally Known t/ OR Produced Identificationa ersonally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of N y Public-State of Flori a) (Signature of Not Public-State of Florida
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Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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