HomeMy WebLinkAboutBuilding Permit Application 1
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: INI\CuA '01 4 Permit Number: ` G1-05- O%
RECESYTEDi
COUNTY I
FLORID �1AYDi'3
A
Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie County
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: HURRICANE SHUTTERS
P=ROPOSED IMPROVEMENT LOCATION . ;� _. .. _ . _ , ,
Address: 6533 GAVIOTA COURT; Fort 17 e,rce FL 3 it irS/
Property Tax.ID#: 1306-500-0017-000-9 Lot No. 2
Site Plan Name: ALBERT THOMAS Block No. 38
Project Name: ALBERT THOMAS
DETAILED DESCRIPTIONsOF WORK
INSTALLATION OF ONE (1)ACCORDION HURRICANE SHUTTER
CONSTRUCTION INFORMATION: '
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank Gas Piping '1_Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2423.55 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name ALBERT THOMAS Name: MIRIAM VAN TASSEL
Address: 65533 GAVIOTA COURT Company: DVT HURRICANE SHUTTERS, INC 1
City: FORT PIERCE State: FL Address: 3100 N KINGHS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE __ State: FL
Phone No. 772-464-5677 Zip Code: 34951 Fax: 772-794-15901
E-Mail: i 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ;,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable:
Name: Name:
Address: Address: f
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."
1 k PUI--63 (:::::\---AraPi U
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Signature o Owner/Lessee/C ntractor as Agent for Owner Signature of/Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF S�. COUNTY OF • �''� -
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 21 day of fl 0-1 ,20 l 7 by this Z$ day of t—\c'w ,20 1 1 by
�'�iCts V v\ i( ss - inkriary- van
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 Identification
Produced Ft— D 1---- Produced_ ._ DL
ejttri "07v
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(Signature of Notary Public-State Florida) (Signature of Notary Public-Stat f Florida)
Commission No. r �„V"%4,� ELaSEN)VAUGHN i Commission No. "'pt.,,� (ala N VAUGHN t
,_ -State of Florida-Notary Public _z�'�,`State of Florida-NotaryPub is
1.:1111M144: Commission # G9 370070 100_ ' Corhmission • e•
uo F`Qf,. My Cnmmkalon Explydo .,, o„';;;.� y Co missionlEx lres
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REVIEWS FR PLANS VEGETATION ,__.-.....•,-22. ,,,4 :Id _: _
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW R r rf
DATE
RECEIVED
DATE
COMPLETED 1
ley.2/7/19 1