HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: lc
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Building Permit Applicatiobi 4,
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Planning and Development Services
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Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential i
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PERMIT APPLICATION FOR:
Shutter
PROPOSED,IIVIP.ROVEMENT LOCATiC►N:
Address: Allen Randolph
Legal Description: Spanish Lakes Country Club Village Leasehold Estates(OR 2389-639)That Part of SEC As
Shown In OR 2389-639 Being Lot 1 Calle De Lagos(0.15 AC-6534 SF) Q fly
Property Tax ID#: 1.394--500=0087=000-5 �,�t�[ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED`DE5CRIPTION CIF WORK:
To install seven accordion shutters
CONSTRUCTION,INFORMA TibN'
Additional work to be Dertormed under this permit—check a appy:
HVAC Gas Tank Gas Piping _Shutters a Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
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Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 3200.00 Utilities:0Sewer 0Septic Building Height:
OWNER%LESSEE CONTRACTOR:
Name Allen Randolph Name: Jeff Jackman
Address:1 Calle de Lagos Company: Master Craft Aluminum Products j
City: Ft Pierce State:_ Address: 1634 SE Niemeyer Cir it
Zip Code: 34951 Fax: City: Port St Lucie State:FI!I
954-892-9393 34952 772-335-0860
Phone No. Zip Code: Fax:
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
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
5UPPLEMENTAL,CONSTRUCTION'LIEN,LAUD IN°FORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: —Not Applicablell
N am e:Allen Ran*Aa4 N a m e
Address•
Allen r�ud Address:
City: State: City: PortSt-L Fe State: I
Zip: Phone Zip: Phone: i
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable,
Name: Name:
Address: Address:
City: City:
Zi p: Phone: Zip: Phone:
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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
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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.
Signa aofO e ssee/Co ractor as Agent for Owner Signatur o e older
STAT O A ST ' �
COUNTY OF 'S • ' a COUNTY OF S f , 11AA6 �-
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 'I(Aday of 20_4 by this 1,e day of plc ,�t� 20 by
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'S� �' Jae l�trn►, e-4 JAc-k«.—
Name of person making statement Name of person making statement
Personally Known V**" OR Produced Identification Personally Known_ue� OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
A
Sheryl D.Moons S�D.Moore
Commission No. NOT BLIC
� � Commission No. �AN --P , �I
�s c6TARY PU� )
STATE OF FLORIDA w f '.: 3
mrr�#Ff 942382 STATE OF FLORIDA
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Cor2382
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Expires 1/15120 ZU
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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