HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Oci Date: _ Z 1 Permit Number: (( f��p qqtt((Lrr
CSGM�d.IL Ie4.`
- Building Permit ApplieatiofrrmSt.""" Department
Lucie county
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 X
PERMIT TYPE:HURRICANE SHUTTERS
PROPOSED IMPROVEMENT`LOCATION:
Address: 6603 Fort Walton AVE Fort Pierce FL, 34951
Property Tax ID#: 1301-612-0100-000-7 Lot No.20,21
Site Plan Name: Block No. 122
Project Name: Raymond D Roberts
DETAILED'DESCRIPTION'OF WORK:
INSTALLATION OF ELEVEN (11)ACCORDION SHUTTERS AND THREE (3) BAHAMAS HURRICANE SHUTTE
CO.NSTRUCTI:ON 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:$ $14,545.32 Utilities: —Sewer —Septic Building Height:
"01NNER/LESS'EE: � � � � CONTRACTOR:
Name Raymond D Roberts Name:Miriam Van Tassel
Address:6603 Fort Walton Ave. Company:DVT Hurricane Shutters Inc.
City: Fort Pierce State:_ Address:3100 N Kings Hwy
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-332-4721Zip Code: 34951 Fax: 772-794-1590
E-Mail:robtz246@yahoo.com Phone No772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail dvthurricaneshuttersinc@hotmail.com
from the Owner listed above) State or County License24394.
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.
i
S P.PLOEMEN1A+L CONSTRUCT10N. LIEN LAW INFORMATION:
F �s
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 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 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."
-
Signa re of Owner/Lessee/Contractor as Agent for Owner Signature of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF f ycu Cae _ COUNTY OF
The forgoing instrument was acknowledged efore me The forgoing instrument was acknowledged before me
this c9—day of 20 tfillby this Qday of 2 by
,In9cnc�n� Cr
Name of person making statement. NaMe of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Q� �7 Type of Identification
Produced Iy l . Produced?)JCU I �dL4111__
W
(Signature of Notary Public- to of Florida) (Signature of Notary nill e of FI i
AA Q
i6:Stat dot Flo�r149-N!;G
HN
Commission No. ?9 mi��®g otery Public
Commission No. �c Com
ELLEN VAUGHN „°F� �` My Co GG 2700
`�4pNY PVAi mission Ex s
_ October 9
JM.
;State of Florida-Notary Public Aire
i9Vp�i�o"s` M Commi si r
REVIEWS IF ) ����t„" ZOUIN sober M,MOR0 PLANS VEGETATION SEA TURTLE MANGRO
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.