HomeMy WebLinkAboutBuilding Permit Application All APPLIC,�LE INFO M r BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ps01 Permit Number:
FRIECEIVED
• Building Permit ApplicrPlanning and Development Services 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
PERMITTYPE: HURRICANE SHUTTERS
-PROP®°SE® IMPR®UEME.NTLOCA�TI®N w"
Address: 4916 PALEO PINES CIRCLE, FORT PIERCE, FL 34951
PropertyTax ID#: 1312-801-0102-000-5 Lot No. 299
Site Plan Name: HEMBREE Block No.
Project Name: HEMBREE RESIDENCE
Y
INSTALLATION OF THREE (3)ACCORDION HURRICANE SHUTTERS
AcIffie"O'NSTRl1C�T�lON
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:$ 1,323.76 Utilities: —Sewer _Septic Building Height:
®WNER/LESS`EE: CORITRAClOR
M11 s it>,
Name JOY HEMBREE Name: MIRIAM VAN TASSEL
Address: 4916 PALEO PINES CIRCLE Company: DVT HURRICANE SHUTTERS, INC
City: Fort Pierce State: F/- Address: 3100 N KINGS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE State: FL
Phone No. 772-460-5020 Zip Code: 34951 Fax: 772-794-1590
E-Mail: loyladyfish @bellsouth.net 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 24394
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.
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
wR YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signaturetof Owner/Lessee/Contractor as Agent for Owner Signature ofCrbntractor/License older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF `ak- I-,a-',K COUNTY OF 4,)r
The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me
this \ `�dayof Cbl 20 by this �� day of 20NI by
�:t s". ,nr. y q-.n. -C'�15s�1 - +r.',r:r.•nom. V �y. �"►SSQ.1
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
(Signature of Nota ublic-State of Florida) nature of Not Y - a e o �IIi*IEG1YENS
ea I EAN WIE GNB ' MY COMMISSION#GG 022023
Commission No. �'�-Z 2 �`S gGGO 2�o ission No. G 14
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COUNTER EW REVIEW REVIEW REVIEW REVIEW REVIEW
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