HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �(
Date:
f r,0 Permit Number:
RECEIVE®
COUNTY
- Building Permit Applicatio APR 12 2019
Planning and Development Services ST. LUe'e!PO4 i�
Building and Code Regulation Division – – _ _�?�atttting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: HURRICANE SHUTTERS
�P:-ROPOSED'INCPROUEMENT LOCATION' j ` ' ;�• = ':
Address: 8505 IMMOKOLEE ROAD, FORT PIERCE, FL 34951
Property Tax ID#: 1335-230-0001-000-6 Lot No.
Site Plan Name: THOMAS OSTEEN Block No.
Project Name: THOMAS OSTEEN
A
INSTALLATION OF SEVENTEEN (17)ACCORDION SHUTTERS •
t
CONSTRUCTI,OI� INFORIVlAT10N n§ M
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:$ 7,226.17 Utilities: —Sewer —Septic Building Height:
„`xx:-`�a
OW /LESSEE CONTRACTOR ,•H
NameTHOMAS OSTEEN Name: MIRIAM VAN TASSEL
Address:8505 IMMOKOLE ROAD Company: DVT HURRICANE SHUTTERS, INC
City: FORT PIERCE State:_ Address:3100 N KINGS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No.772-201-1512 Zip Code: 34951 Fax: 772-794-1590
E-Mail:tom@osteenappraisal.com Phone No 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail dvthurricaneshutte'rsinc@hotmail.com
from the Owner listed above) State or County License 24394
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 C0: RUCTI N,L1EN LAW (N:FO:RMATION
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 thepermit 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."
Au-) C
Signatu of Owner/Lessee/Cont actor as Agent for Owner Signature f Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF . COUNTY OF '�>*.L_ )%>,-
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me
this_a.day of 0.j!6\ 201 by this\ day of p C i\ 20 NA by
�''�^�� �� a►yv1 � d►n �gSSe., 1N�'�v`og� ��'� ��.b5��
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identifi1ff�on Type of Identification
Produced Produced
(Signature of Notary blic-State of Flori �S (Signatur dry, Pu (P
Ft1EON Lg , ?o�P?:..,s�o's MY Co 11g 2020
Nj*10 GG p220 ;s:' := eCem en cis f i
Commission No. DtJi91# Tag Zo2o �s Commissio -� taryPubVic i
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REVIEWS F I�fi G SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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