HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE�INO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:,X19 '2i&, 2019 Permit Number: o lX
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RECEIVED
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Building Permit Applications OCT.21 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucle County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMITTYPE: HURRICANE SHUTTERS
PR'OR' EP0,lMPROUEMENT LOCATION
Address: 17729 CANAL C-24 RD , FORT PIERCE, FL
Property Tax ID#: 3223-211-0001-000-9 Lot No.
Site Plan Name: OSIF C24 ROAD Block No.
Project Name: OSIF C24 ROAD
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3DET�AILEDDESCRIPTI®N O`FWORK . .
INSTALLATION OF ELEVEN (11) ALUMINUM STORM PANEL HURRICANE SHUTTERS
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C. NSTR'UCTIONNN, ATI®N '
Additional work to be performed under this permit–check all that appl
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_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
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_Electric _Plumbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 2,316.01 Utilities: —Sewer —Septic Building Height:
OWNERS/L�ES�SEE�
CONTRACTOR:`f
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Name OSIF LLC Name: MIRIAM VAN TASSEL
Address: P O BOX 14049 Company: DVT HURRICANE SHUTTERS, INC
City: Fort Pierce State: Address: '3100 N KINGS HIGHWAY
Zip Code: 34979 Fax: City: FORT PIERCE State: FL
Phone No. 772-201-1230 Zip Code:, 34951 Fax: 772-794-1590,]
E-Mail: Phone No 772-794-1581 j
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
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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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DESIGNER/ENGINEER: j _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State: !I
Zip: Phone Zip: Phone:
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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
WJLTWYOUR LENDER OR AN ATTORNEY BEFORE RECORDING WUR NOTICE OF COMMENCEMENT."
Signature of caner/Lessee/Contractor as Agent for Owner Signature of Contrac or/License Holder
STATE OF FLORIDA STATE OF FLORIDA r
ITheCOUNTY OF '�y`G�__ COUNTY OF 1 /IF,—
The
for oln instrument was cknowledged before me The f oin'g instrument as acknowledgedbefore me j
this 2 .day of 20 by thi day of Q 20 by
1'�c arcs \hw-, -ts- 2Q yor1 t�sk i�
Name of person making statement. Name of person making statement. m
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced !1 L— Produced
(Signature of NotaryPublic-State of Florida) (Signature of Notary Public-Statadt Florida
+aVP�% ELLEN GHN ++rpu,, =F1.
Commission No. o.P o- Q8 Commission No: ,.►� ublic
of Flori tary Public ;� tateCommission #GG 270079 +� co079esOtober22, 022 ''��plu ,
REVIEWS OR PLANS VEGETA
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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