HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRO
DESIGNER/ENGINEER:
QN LIEN. LAW INFORMATION:
Not App
Name: l
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE MOLDER:
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: gNot Applicable
Name:
Address:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY:
Name: _
Address:
City:_
Zip:
1 certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 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 carded and posted on the jobsite
before the firfst inspection. If you intend to obtain financing, consult h lender or an attorney before
commencing(/work or rece-rd' our Notice of Commencement.
as Agentfo
of
STATE OF FLORIDA STATE OF FLOR (Ole,COUNTY OF �L LL COUNTY OF � I. C f
The for ping instrument was acknowledged before me
this day of ✓ L -e 20 %y
U e
(Name of ers ackn edging )
(Signat re of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.6 (Seal)
n1�v aue
a
Revised 07/15/2014 nY'FpF fL�
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
ALYSSA A.T
The far Ding instrument was acknowledged before me
this day of ti , 20 (by
(Name of persocknonrledging) l
(Signature of rotary Public- State of Florida )
Personally Known �OR Produced identification
Type of Identification Produced
Commission No.,�3 6 (Seal)
Expires January 28, 2023
Sanded Thru Budget Notary SerYkes
SUPERVISOR PLANS
REVIEW REVIEW
ALYSSA A,T.
t * ..vniwom�rrn Vt7L
�' 04 ExplresJanuary 28,
Bonded Thru Budget Notary
VEGETATION I SEA TURTLE I MANGROVE
REVIEW REVIEW [ REVIEW
ALL 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
Address:
Legal Description: -Pt �' V
1� 1 G
Property Tax ID #: �- C� do b c) Q Lot No.
Site Plan Name: - 4- Block No.
Project Name: DQ I W
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: j
INSTALLATION OF ('2J FBC-APPROVED ACCORDION SHUTTERS
CONSTRUCTION INFORMATION:
Additional work to e Derformed under this permit - c ec a apply:
0HVAC 6as Tank ❑Gas Piping Shutters 0 Windows/Doors
11 Electric ElPlumbing Sprinklers ElGenerator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ q 1�
SQ. Ft. of First Floor: _
Utilities: Sewer 0 Septic
Building Height:l5'
OWN ER/LESSEE:
CONTRACTOR:
Name
Name: SAMULE ZAZA
Address: �n ti'C-�
Company: JUST SHUTTER IT INC
City: Q ), �G� (�1 tiil; L LState: 3;:��
Address: 1029 SW S. MACEDO BV
Zip Code:°j� T_ Fax:
City: FORT ST LUCIE State: FL
Phone No. 1--I a 0j 9 q / i
Zip Code: 34984 Fax:
E-Mail: .)U GAY L— I' CMG Y ci kCOM
Phone No. 772-201-9919
Fill in fee simple Title Holder on next page ( if different
E-Mail: JUSTSHUTTERIT@GMAIL.COM
from the Owner listed above)
State or County License: 24293
PI value V1 i.V11bL9u4.6lUr3 IS ?4aVU UT MOre, a KCLUKUCU r4once OT Lommencement is requireci,