HomeMy WebLinkAboutBuilding Permit Application ALL APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: lJ 1
/ RECEIVED
Building Permit Application AUG 2 2.2019
Planning and Development Services ST. Lucie County, 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'I11lIP,ROVEMENT.LOCATION.
Address: 5009 Paleo Cir, Ft Pierce, FI 34951
Legal Description: Holiday Pines S/D-Phase 11-13-Lot 338(MAP 13/13N)
Property Tax ID#: 1312-801-0141-000-0 Lot No.338
Site Plan Name: Holiday Pines Block No.
Project Name: Cichocki
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION F CORK: «°
Installing seven accordion shutters on the home.
CONSTRUCTI{ N INFORIULATION
Additionalwork to be nertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$50.00 Utilities-t' Septic Building Height:
0WNER/LES "IE E: CONTRACTOR:
Name Regina Dietrich&Thomas Cichocki Name: Jeff Jackman
Address:5009 Paleo Pines Cir Company: Master Craft Aluminum Products
City: Ft Pierce State:Fl Address: 1634 SE Niemeyer Cir
Zip Code: 34951 Fax:772-335-0860 City: Port St Lucie State:FI
Phone No.772-335-1177 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.
' a
SUPPLEMENTAL CNSTRU.CT'ION LIEN LAW INFORMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Regi .o ooki Name:�
Address: Address:
City: Ft &- State: City: Port-' E ie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add cess: -ir 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 Commencement.
Signatur0FFL
Le see/ ntractor as Agent for Owner Signatur f Co ctor nse Holder
STATE I A STAT OF F RIDA
COUNTLu' COU St Lucie
The forgoing instrume was acknowledged before me The forgoing instrument was acknowledged before me
this q Lday of 20( by this�day of 204' by
Name of person aking statement Name of person making statement
Personally Known OR Produced Identification Personally Known 1/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-S*E*rea
�M oo
D.M=e (Signature of Notary Public-State of Florida)
NOTARY PUBLIC BherA D
Commission No. MATE OF FLORIDA Commission No. NOTARYPIL19WO
Comrn#FF942382
1/9612020 M- STATE OF FLORIDA
Commg FF942382
qRW Ewres 919 612020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17