HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/17/2020 Permit Number: lid► �3
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PBuilding Permit ApplICatl6w
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Planning and Development Services St Lp eDCoUty ent
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
PtOPOI� IIUI�RC)tlEMENT LOCA3'IN
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Address: 3311 Selvitz Road
Property Tax ID#: 2430-144-0001-000-h Lot No.
Site Plan Name: Block No.
Project Name: Pulliam
Q '`AILEDDES-CRIPTIONV OF WORK, :,r q
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Install 8 Accordions, Install 2 Roll Shutters
"fVQ rNSTRUGT ONsIN flRMAT N � -
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping X Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 6,161.00 Utilities: —Sewer —Septic Building Height:
'r NiV'I= j�Es IjE f coNTRA OR
Name Diane Pulliam Name:Michael Heissenberg
Address:3311 Selvitz Road Company:Expert Shutter Services
City: Port Saint Lucie State: FL Address:668 SW Whitmore Dr
Zip Code: 34981 Fax: City: Port St. Lucie State:FL
Phone No.772-595-1445 Zip Code: 34984 Fax:
E-Mail: I Phone No 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail Permits@expertshutters.com
from the Owner listed above) State or County License 16572
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:rite,Inc. Name:
Address:6355 NW 36th St Suite 305 Address:
City: Virginia Gardens State: FL City: State:
Zip: 33166 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 THEE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER.. ORNEY EFORE RECORDING YOUR NOTICE OF COM MENT
Signature of Owner/Lessee/Contractor as Agent fmr Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S}. Luc:,( . COUNTY OF��.LUO"('_
The forgoing instrum nt was acknowledged before me The forgoing instrumen was acknowledged before me
this�day of 20X by this ( .day of 20.X by
Name of person making statement. Name of person making statement.
Personally Known 141 OR Produced Identification Personally Known V/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of a a
Q� NOTARY PUBLIC (Signature of Notary Public-State of Flo�) Shanon O'Shea
Commission No "�5V U?J c S TpTEOF FLORID We
NOTARY PUBLIC
Comm#GG23g Commission No� Ow TATE OF FLOR D
res g112�02 omm#GG2580 8
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REVIEWS FRONT ZONING SUPERVISOR . PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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