HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /'� /► b`�
Date: To,yl Permit Number: 2WI -
M7T W- i RECEIVED
-- -- Building Permit Applicatic n JAN 2 9 2020
Planning and Development Services ST. Lucie 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
PROPOSED IMPROVEMENT LOCATION:
Address: 2993 CONIFER DRIVE, FORT PIERCE, FL 34951
Property Tax ID#: 1327-801-0076-000-9 Lot No. 187
Site Plan Name: SAM KUCEY Block No.
Project Name: SAM KUCEY
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF THREE (3) NAUTILUS ROLL-UP SHUTTERS -SHUTTERS TO BE ELECTRIC
ELECTRIC WORK BY OTHERS
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply::
_Mechanical _Gas Tank _Gas Piping dl3hutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 12,460.03 Utilities: _Sewer _Septic Building Height:
OW N ERAESS E E: CONTRACTOR:
Name SAM KUCEY Name: MIRIAM VAN TASSEL
Address: 2993 CONIFER DRIVE Company: DVT HURRICANE SHUTTERS, INC
City: FORT PIERCE State: Address: 3100 N KINGS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No.673-316-0487 Zip Code: 34951 Fax: 772-794-1590
E-Mail: Phone No 772-794-1581
Fill in fee simple Title Holder on next page(if different E-Mail dythurricaneshuttersinc@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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT!..
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SignaturA of Owner/Lessee/Contractor as Agent for Owner Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
Th in inst ent as acknowledged before me The ��qqin instr ent was acknowledged,��jefore me
ti day of 2�by thi �'Iday of 20oUJby
Name of person making statement. Name of person making statement.
Personally Known_ )t!f� OR Produced Identification Personally Known Z OR Produced Identification
Type of Identification Type of Identification
Produced A Produced
0 A A L =t"L
(Signature No l b. - (Signature of ary
KAREN S. NIELSEN ++ KAREN S. NIELSE]lic.
`�"YP�°' �°-YP6O�, State of Florida-Not Commissio ( °� ride-No(�ie�l�ublic Commissio I a('�_• ±` Commission #GG 207484 ;. Commission # GG 20741-i My Commission Expires %?, P;� MCommission Expir
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REVIEWS RVISOR PLANSTr RLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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