HomeMy WebLinkAboutBuilding Permit Applicaiton 1 _
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • . 1 Permit Numy 0
r RECEIVE®
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Building Permit Applicatiop JUN 13 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 Count yr FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X'
PERMIT APPLICATION FOR: Shutter
PROPOSED IM PROVE MENTLOCATION,
Address: 6505 Lakeland Blvd
Legal Description: Lakewood Park Unit 10 blk 119 lot 16 & 17
Property Tax ID#: 1301-612-0016-000-1 Lot No. 16 & 17
Site Plan Name: Block No.
Project Name: Wolfe Jeanne
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION`OF WORKjz
INSTALLATION OF HURRICANE SHUTTERS
CONSTRUCTIONS°INFORMATION
Additional work toe e orme under this permit—check a apply:
❑HVAC Ei Gas Tank Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2,081.66 Utilities: []Sewer[]Septic Building Height:
01NLNER/LESSEE:. . ., CONTRACTOR: '
Name Jeanne Wolfe Name: Robert McNally
Address: 6505 Lakeland Blvd Company: Palm Coast Shutters &Aluminum Products, Inc.
City: Fort Pierce State: FL Address: 675 4th St.
34951 i
Zip Code: Fax: City: Vero Beach State: FL
Phone No. Zip Code: 32962 Fax: 772-299-1958
E-Mail: Phone No. 772-299-1955
Fill in fee simple Title Holder on next page(if different E-Mail:.Giovanna@palmcoastshutters.com
from the Owner listed above) State or County License: CBC1262166
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable_ .
MORTGAGE COMPANY: Not Applicable
Name: N/A 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commenc en .
, Cd
Signature of er/ essee/C' tractor as Agent for Owner Signature of Contractor/Lice
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF y�i? kr�l �,V�-Z COUNTY OF INDIAN RIVER COU
The forgoing instrument was acknowledged before me The forgoing instrum n was acknowledged before me
this o�7 day of 09' 20� by this�aday of 20 19 by
J'M ROBERT MC NALLY
Name of pers�or making statement Name of person making statement
Personally Known l/1 OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
P uc Produced
V)
&A"'GL (Ada�
(Signa re of Notar Public-State of FI
(Sign re of Notary Public tate of Florida)
Com i Notary Public Stem of FloCommission No. "i r'r' CYNTM 70My Commisslon GG 2870 �.�.�—Notary Public-State of Florida
Tars Expires 01/26/2023 ` : :•? CommissionNGG096877
'•;; + �';' My Comm,Expires May 15,2021
••1„• NondcdlhraughNalionallotaryAssn.
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Rev.8/2/17