HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: NA eis\ 2-\ -ZS-) n Permit Number: (Cra (57— 053 (
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Building Permit Application kAt1/41
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Planning and Development Services n,,ivotting county
Building and Code Regulation Division T st
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial S Residential X
, PERMIT TYPE: HURRICANE SHUTTERS
PROPOSED IMPROVEMENT LOCATION:::
Address: 7903 KENWOOD ROAD, FORT PIERCE, FL 34951
Property Tax ID#: 1301-605-0226-000-4 Lot No. 26
Site Plan Name: DENIS SULLIVAN Block No. 48
Project Name: DENIS SULLIVAN
OtTA21(04,;00$0tIPTIOW2F.,W0f3K:•.....,„. • .-..: ' . .::. :....'; -.. , -.,..--.'''.: :', .- - ---... --,- - , :,:.. :--:-: :•*. -.:', t-',..
INSTALLATION OF -rev\ olea ACCORDION HURRICANE SHUTTERS
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors
—
Electric Plumbing Sprinklers Generator Roof Pitch
_
— — —
Total Sq. Ft of Construction: , Sq. Ft.of First Floor:
Cost of Construction:$ 5,929.50 Utilities: Sewer Septic Building Height:
41\6400V.,( $:.Et...,:: ;A'......k..7-' -:-- -, ,:-:,,_. . --:.:. :-.:. .-:cdwrikActOR:
Name DENIS SULLIVAN Name: MIRIAM VAN TASSEL
Address: 7903 KENWOOD ROAD Company: DVT HURRICANE SHUTTERS, INC
City: FORT PIERCE State: Address: 3100 N KINGHS HIGHWAY
Zip Code: 34951 , Fax: City: FORT PIERCE State: FL
Phone No. 772-464-9154 Zip Code: 34951 Fax: 772-794-1590
E-Mail: , Phone No 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Maildvthurricaneshuttersinc@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 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: 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."
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CCU–C:1 t'701Uki- V Ct-u -
Signatu of Owner/Lessee/Contractor as Agent for Owner Signature f Contractor/License Holder
STATE OF FLORIDA9 � FLORIDA
COUNTY OF l� COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Th_day of ,20 \°\by this a' day of hen ,201°r) by
IA(ZCP/r),, Van 1 l — ((7Co n \Gn 7-1C 4
Name of person making statement. Name of person making statement.
Personally Known OR.Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identificati
Produced 0 Produced „ 0
EA)
(Signature of Notary Public-Sta of Florida) (Signature of Notary Public-State of Florida)
Commission No. ` 11 ELLEN VAS''_.. Commission o.��, :.
i o� �e,, N wVP� ELLEN VAUGHN
?*�.�,;State of Florida-Notary Public of Florida-Notary Public
41 *= Commission # RG 270079 * 011
-,,,,;;:)11,1,,* My (Commission Expires �a�,�oP.° My Com x7i 079
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DATE
RECEIVED
DATE
COMPLETED
ley.2/7/19