HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��nn
Date: August 26, 2019 Permit Number: qV D
•__ Building Permit Application Aub%110%
Planning and Development Services Depavment
Building and Code Regulation Division petCn�tttn9�e Co��ty
2300 Virginia Avenue,Fort Pierce FL 34982 St.`U
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE: HURRICANE SHUTTERS
PROPOSED"IMPROVEIVENT LOCATION:
Address: 6306 Lilyan Parkway Fort Pierce, FL 34951
Property Tax ID#: 1301-609-0012-000-3 Lot No.12
Site Plan Name: Cooper Block No. 1
Project Name: Cooper Residence
DETAILEDDESCRI'PTI®N ®F WORK
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INSTALLATION OF TWO (2) BAHAMA HURRICANE SHUTTERS
CONSTRUC�TI:ON INFORIVIATION`:
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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
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Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 3,226.44 Utilities: —Sewer —Septic Building Height:
OWNERAA85EE CONTRACTOR:
Name �h- es- ��D 2 r Name: MIRIAM VAN TASSEL
Address:6306 Lilyan Parkway Company: DVT HURRICANE SHUTTERS, INC
City: Fort Pierce State: Address: 3100 N KINGS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE State: FL
Phone No.772-216-40701 Zip Code: 34951 Fax: 772-794-1590
E-Mail: Phone No 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail dvthurricaneshuttersinc@hotmail.com
from the Owner listed above) State or County License 243Rq
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 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:'
Signature of Owner/Lessee/Contractor as Agent for Owner Signature bf Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OF �ik�k I i COUNTY OF a
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 01
f 204 by this 24 day of C�� 20_R by
V G1Yl n t(VY1 r�
Name of erson making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificatio Type of Identification
Produced U l Produced �(
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(Signature of Notary P lic-State of Florida) (Signature of Notary Pub ic-State of Florida)
Commission No ELLEN GHN Commission No (Seal)
S?A-Y PW,
State of Florida-Notary Public �P�Yo�c,� ELLEN VAUGHN
�E a�° y Commission -Expires, o o on a-Nota y Public
REVIEWS �'f8`�`w Y7OM[14 22, OSUPER OR PLANS VE 1„� i '0E h OVE
REVIEW V��2, 20 KPI W
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19