HomeMy WebLinkAboutBuilding Permit Application ov
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: r Permit Number:
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Building Permit Application
Planning and Development Services (�jN'
Building and Code Regulation Division 41 90�
2300 Virginia Avenue,Fort Pierce FL 34982 �e co
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential vv
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PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION:6776 Dulce Real
Address: 6776 Dulce Real, Fort Pierce, FL 34951
Property Tax ID#: 1306-501-0787-000-0 Lot No.20
Site Plan Name: Block No. 63'�
Project Name: Ann M Phillips
DETAILED`DESCRIPTION OF WORK:
-:::�wSTA-I( f} c c.o i S zJ ( �aGs
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[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:$ D Utilities: _Sewer _Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
Name Ann M Phillips Name:Edward J. Heritage
Address:67767DuIce,Beal Company:Folding_Shutter Corporation 'I
City: Fort Piece` State:_ Address A862,Dr.,Martin Luther King Jr Blvd �
Zip Code: 3495,1...` Fax::NiA City: West'Palm=Beach State:FL
Phone No.77278.82-9244.:. Zip Code: 33404- Fax: 561-640-8204
E-Mail:NIA Phone No 561-683-4811
Fill in fee simple Title-Holder on next page(if different E-Mail info@foldingshutters.com
from the Owner listed above) State or County License SCC131151041 j
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:
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."
Signature of Owner/Le
m#ect&as Agent for Owner Signature of Conte r License dgr
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Bean COUNTY OF Palm Beach
The for oing instrume vias acknowledged before me The for oing instrum�was acknowledged before me
this day of -J U 20_ by this day of Jy y ,20_ by
Edward J.Heritage Edward J.Heritage
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 Produced
of Nota Publt1b
vans
(Signature ryh �A Evans (Signature of Notary Mte NOTARY PUBLIC NOTARY P BLIC
Commission No. ST IDF FLORIDA Commission No. STATE(TSWIDA
Expires 10111 mnoo
Comm#GG262789 .N �� Comrn#GG262789
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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