HomeMy WebLinkAboutBuilding Permit Application L.C�
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 c�L OZ�-llf�
•
- - - - - -_ Building Permit Application
f
Planning and Development Services
Building andl Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:Hurricane Shutter
PROPOSED INPROVE M.ENT LOCATION':8833`FirstTee Rd
Address: 8833 First Tee Road, Port St Lucie, FL 34986
Property Tax ID#: 3334-500-0050-000-5 Lot No.39
Site Plan Name: Block No.
I
Project Nami: Susan A Mullen
FAlETLED DESCRIPTION OF WORK:
AtvTDR i 2 �v Q ?N . 5 1 U 'Te OL S
eOLS
���G /4•R�i�3$�'UtJ �dG
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that aZh
l -
_Mechanical _Gas Tank _Gas Piping tters, =Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
,Cost of Construction:$ ) R5_5 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Susan A Mullen Name:Edward J.Heritage
Address:8833 First Tee Rd Company:Folding Shutter Corporation
City: Port St Lucie State:_ Address:
Zip Code:.34986 Fax:N/A City:: ., ., •.,, �,G V;?c,. State:FL
Phone No.917-841-7329. Zi ''Code:, r Fax: 561-640-8204
r} ::;
E-Mail:susanm719@yahoo.com P..hone.No 561=683=481:1
Fill in fee simple Title_ Holder,on next page(if different E-Mail info@foldingshutters .com
,� <-,
from the'Ovoner..listed-above)';:, State or County License SCC131151041
If value of'c66struction,is-$2500'/or inore,a RECORDED Notice of Commencement is required.
If value_of LiVAGis$7500'or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:, '° 1 _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X 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 of recording our Notice of Commencement.
Signature of Own ess r as Agent for Owner Signature of Contr5MF License Ho
STATE OF FLORIDA STATE OF FLORIDA
CO U NTY OF Palm Beach CO U NTY OF Palm Beach
The forgoing instrumentw s acknowledged before me The forgoing instrumee t%yas acknowledged_before me
this R6 day of t" 201� by this o?aday of 4"Eb ,20 17 by
Edward J.Heritage Edward J.Heritage
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
of Notary Public-State of Florida
(Signature y ) (Signature of Notary Public-State of Florida)
Commission No.GCr.aLq? ref of eal) Pa laA Evans Commission No. G'G'2`2 ? (Seal)
o�* n NOTARY PUBLIC
c OF FLOR DA
REVIEWS FRONT ZO ?t"WT90W
��tg PLANS VEGETATION SEA TURTLE MANGROVE
- COUNTER REVI 11/2 2 EVIEW REVIEW REVIEW REVIEW
DATE 'fir amela Evans
RECEIVED c� NOTARY U
DATE ? E O'FLORIDA
COMPLETED si Comm#G 2
ev.9/26/18 r-xpires 10/11/2022