HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ] j
Date: Permit Number:
Building Permit Application
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 APPLICATION FOR: Shutter
,PROPOSED IMPROVEMENT.LOCAI"CON u
�v
Address: 6013 Adonidia Place
Legal Description: Palm Grove S/D Blk. L Lot 36
Property Tax ID#: 3410-503-0374-000/4 Lot No.
Site Plan Name: Palm Grove Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
771
DETAILED DESCRIPTION 0E WORK '.
Install accordion shutters on ten openings per layout.
CC>NSTRUCTI,ON INFORMATION
Additional work to be nertormed under t ispermit—c ec a appy:
HVAC Gas Tank Gas Piping �_Shutters Q Windows/Doors
Electric Plumbing OSprinklers 0 Generator El Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3,800.00 Utilities: Sewer E]Septic Building Height:
DINNER/LESSEE CONTRACTOR:
Name William&Susan Leahy Name: Jeff Jackman
Address:6013 Adonidia Place Company: Master Craft Aluminum Products
City: Fort Pierce State:FL Address: 1634 SE Niemeyer Circle
Zip Code: 34982 Fax: City: Port St. Lucie State:FL
Phone No.772-828-3164 Zip Code: 34952 Fax: 335-0860
E-Mail: Phone No. 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.
AM �
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: P-hone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Add re ss:. 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 ori 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. .
Signatur of 61 r/Losse /Contractor as Agent for Owner Sigrratulvdf bo actor/Li ense Holder
ST E-O F IDA 41-:)Lt A
COUNTY OF SL Lucie COUNTY OF St Lucie
The for Ing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this S9day of iU01trr✓,lidr 20 M by this 5hiday of Q 6v-lw ,. ,20 11 by
Jeff Jackman Jeff Jackman
Name of person making statement Name of person making statement
Personally Known X OR Produced Identification Personally Known x OR.Produced•Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public- F ) (Signature of Notary Public-State of Florida)
Commission No.o NOTARY PU 1� ShPayl D'Moore
E OF F (5%A Commission t NOTARY PUBLIC(Seal)
wa Comm#FF942382 ° STATE OF FLORIDA
Ir 1/15/2020 w Comm#FF942382
REVIEWS FRONT ZONING -SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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