HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a Permit Number:
a =FEB
Building Permit Application
.Planning and Development Services 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
PR`O?O5ED 11111PROVEMENT IOCATIQN
Address: 7301 Pacific Ave
Legal Description: LAKEWOOD PARK-UNIT 4- BLK 39 LOT16 (MAP 13/11N) (OR 1203-0772: 1248-1490)
Property Tax ID#: 1301-604-0220-000-9 Lot No. 16
Site Plan Name: Block No. 39
Project Name: Thompson Carolyn
Setbacks Front Back: Right Side: Left Side:
J11L DESCR)PTION ?
F WORK
NETIAV'n�
Installation of 9 Accordion shutters
Additional work toe e orme under this permit-check a apply:
HVAC 11 Gas Tank E]Gas Piping _Shutters Q Windows/Doors
11 Electric ❑Plumbing Sprinklers Il Generator F]Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 6,806.68 Utilities: Sewer 0Septic Building Height:
OWNERjLfS E,E '.' `� z CONTRACTUR
P.euva ,�:°s., ..• „e ._.• .2, .,wJ_.*s :. c r,.a.,.r - _ ;' sa,
t
Name Thompson Carolyn Name: Robert McNally
Address: 7301 Pacific Ave Company: Palm Coast Shutters&Aluminum Products, Inc.
City: Fort Pierce State: FL Address: 675 4th St.
Zip Code: 34951 Fax: City: Vero Beach State: FL
Phone No. 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: Giovanna0palmcoastshutters.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: NVA Name:
Address: Address:
City- State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: i 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 theermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or angcovenants 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,
accessary 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 tenderor attorne b ore
_
commencing work or recording your Notice of Comme 'Qommit,.,
Signature of Owner/Lessee/Contractor as Ageril for Owner ignature of Contracto rise Hol
STATE OF FLORIDA;, STATE OF F1 RIDA
RIVER _0 -N
COUNTY OF COUNTS'OF 1INDIA111 RIVER CC
The forgoing instrument was acknowledged before me The forgoing instrument waas c wIdgc1 before me
this%% day of 20 by this 2_i!�day of instrument
20 IS by
Thompson Carolyn
_RT MIC NALLY
Name of personXaking statement Name of person making statement
Personally Known� OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produ Produced
(Signature of Notary P (Signa u e of Notary Public-fthte of Florida)
V_T
DARLEN HI:EISERMAN CYNTHIA A.J I
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Sta iorida
Commission No. Nota iigab-State of Flodda Commission No.(11-61 0q(I A Sta
Notary Public
commissilon GG 071305 Commission# 0 817
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My Comm Expires Jun 5.2021 a 5,2021
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA R Vr
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.872717