HomeMy WebLinkAboutBuilding Permit ApplicaitonALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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 xxx
{ PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 'A c,(-
Legal Description: D��-3 (- '11 ��� 1 (^?L'Ij �j ire_
Property Tax ID #: `, 7 C�� '�, n C)o Lot No.
Site Plan Name: �Y`(;Y_r,��n Block No.
Project Name: FLoal e r
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (�1 FBC-APPROVED ACCORDION SHUTTERS LY]
i ( C[1ffCAV P4VW_1s
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit— check a appy:
HVAC '[] Gas Tank OGas Piping OGenerator
Shutters Windows/Doors
11 Electric E] Plumbing OSprinklers Roof Roof pitch
Total Sq. Ft of Construction: SQ. Ft. of First Floor:
Cost of Construction: $_2=o5-
_2 � i �` 5- - Utilities: Sewer L ] Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR:
Name E tri- Ln (!a I-.
Name: SAMULE ZAZA
Address: I C r 6 ail it
Company: JUST SHUTTER IT INC
City: State:�
Address: 1029 SW S. MACEDO BV
Zip Code: Fax: �J
City: PORT ST LUCIE State: FL
Phone No.1 �� �1
E-Mail:G VW C l I
Zip Code: 34984 Fax:
Phone No. 772-201-9919
Fill in fee simple Title Holder an next page if different
E -Mail: J USTSH UTTER IT@GMAIL.COM
from the Owner listed above)
State or County License: 24293
IT vatue OT consiruction is , zsuu or more, a 11MORDED Notice of Commencement is required.
SUPPLEMENTAL CONTRUON LIEN LAV
DESIGNER/ENGINEER: Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
State:
Not Applicable
INFORMATION:
MORTGAGE COMPANY:
T Name:
_ Address:
City:.
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit,
of Applicable
State:
Applicable
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 5t, 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, const with lender or an attorney before
com ncing v7m* or recording your Notice of Commencement.
Owner/Lessee/Contractor as Agent for Owner
Holder
STATE OF FLORIDA3+ STATE OF FLORIDA �?
COUNTY OF l i C 1 _ COUNTY OF J
The for g instr ent w s acknowledge efore me
this day of 2D i4 __by
5 Y"Y,1 7 Gx
(Name of person acknowledgin
(5ignat f
a of Notary Public- State of Florida )
Personally Known OR Produce Identification
Type of Identification Produced L —
Commission No. (,b )
ALYSSA A.T. Bov
Commisslon # GG 2
The for oing instru nt wa fore me
this day of � .20 by
(Name of person acknow edging )
(Signature of ao-tary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced ID2—
Commission No.�& (}5-q 50 (Seal)
Revised 07/15/2014 ` OF FLID" Bonded Thru Budpt Notary Services
ALYSSA A.T. BOWSER
* amm ss on G 295930
r Expires January 28, 2023
Bonded Thru Budget Notary Services
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