HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Cp�7.y \ Permit Number: VV C16'd y o O
CRCOETVEOBuilding Permit Applicatio ?�Planning and Development Services nty, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:;
Address: 450 Campbell Road Fort Pierce FL 34945
Legal Description. Corbin Acres Lot 5
Property Tax ID#. 2309-800-0005-000/5 Lot No.5
Site Plan Name: Corbin Acres Block No.
Project Name:
Setbacks Front Back: Right.Side: Left Side:
DETAILED DESCRIPTION PF WORK ',
Install accordion shutters on four doors and fourteen windows.
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all apply:
HVAC Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric E Plumbing []Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 5,100.00 Utilities:Sewer F]Septic Building Height:
OWNER/LES5E 'CONTRACTOR
Name Teresa H. Corbin Name: Jeff Jackman
Address:450 Campbell Road Company: Master Craft Aluminum Products
City: Fort Pierce State:FL Address: 1634 SE Niemeyer Circle
Zip Code: 34945 Fax: City: Port St. Lucie State:FL
Phone No.461-4510 Zip Code: 34952 Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page(if different E-Mail: mastercraftaluminum@gmail.com
from the Owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Add ress: 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 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 Commencement.
Signatur of r/L ssee/Contractor as Agent for Owner Signat a ntra or/License Holder
STATE RIDA STATE O ORIDA
COUNTY OF-SL Lucie COUNTY OF 9L Lucie
The fo going instrument was acknowledged before me The forgoing instrument was acknowledged before me
this Mday of J?A_ - 20J4 by this day of 204 by
Jeff Jackman Jeff Jackman
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR.Produced.Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary ublic-State of Florida ) (Signature of Notary Public-State of Florida)
Sheryl D.Moore .Sheryl D.Moore
Commission No YPUBL(Ceal) Commissio NOTARYPUBLIC Seal
STATE OF FLORIDA —STATE �,ORIDA( )
Cw n#FF942382 Comm#FF942362
E W Eixpl es —me 110 1 MAP
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17