HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: ,3 ^ / j I Permit Number:
RECEIVED
i..
' MAR i , X19
Building Permit Applicatio
ST. Lucie County, Permitting
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 TYPE:Storm Shutters
PROPOSED I'MO'ROVEMEN.TLOCATION"',
Address: 3409 Bent Pine Dr., Ft Pierce
Property Tax ID#: 1327-801-0027-000/1 Lot No.23&24
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION 'O'F"`WORK
Install roll down shutters at exterior windows and doors
CONSTRUCTION INFORMATION
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:$ .30, y00 -' Utilities: —Sewer Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name 1?6N,.go•J ,VeGe"X Name:CaP,s///��,0�D,�Ic0�1S�1 .� ►vs•n'
Address: 3%0? R6's p�^'o�R Company:C�P-4nlDis Co�Srrwvt-�a�, IrJC
City: F-r. P16a-f6 State: FL- Address: 'P-O • 6-X 9$1765'-
Zip Code: 38451 Fax: City: J>m r S-r .Uy(,ib State:
Phone No. ?7Z) 336 - 7 ZqO Zip Code: 3`/S�°o Fax: '77Z)78S'-$198"I
E-Mail: C,�o 600-u06 CvNST"VC T ioN f-/C. Phone No 772) 336-72,10Fill in fee simple Title Holder on next page(if different E-Mail 626 ej
from the Owner listed above) State or County License CCS•C 1 5-v 5 127
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.
SUPPLEMENTjAL CONSTRUCTION LIEN LAW INFORMATION
_. ,.. =
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: 3,a ms .os e,..l n 1w9L- 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
- �fL+�S• P12o S.
ig ture of Owner/Lessee/Contractor as Agent for Owner ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST . l.0 C)6 COUNTY OF Sr. Ly ILA b
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged befo
this ! day of j hi-my c+A ,20 19 by „ this L day of VAAd-c.l l ,20 I S by ,��
moo _
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Name of person making statement. °% •��� Name of person making statement.
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Personally Known 1� OR Produced Identifi t*; r Personally Known ✓ OR Produced Identific ion� CD W
Type of Identification 0 °=' Type of Identification =o B Z
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Produced ,z Produced C 3 0 o r—
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Signature of Notary Public-State of Florida) N� v ' ature of Notary Public- ate of Florida) Nv
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Commission NOI."ll. (Seal). `� Cn=Z Commission No. 'l6 ZS 1 O 6 (Seal) w `"�Z
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19