HomeMy WebLinkAboutBuilding Permit Application t
All APPLICABLE INFO,MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:- 2020 Permit Number: a.d 03-�d3a
•
EnM:AR0;27020
IVED
Building Permit ApplicataPlanning and Development Services nty,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: 9414 Poinciana Court, Fort Pierce, FL 34951
Property Tax ID#: 1334-503-0016-000-8 Lot No. 14
Site Plan Name: Waltz Block No.
Project Name: Waltz
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF ONE (1) NAUTILUS PULL DOWN SHUTTER WITH REACH HANDLE AND
SIX (6) NAUTILUS ROLL UP SHUTTERS WITH CRANK
NObtECTRICITY
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping +!" Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 4,849.27 Utilities: —Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name GERALDINE WALTZ Name: MIRIAM VAN TASSEL
Address: 9414 POINCIANA COURT Company: DVT HURRICANE SHUTTERS, INC
City: Fort Pierce State: EL Address: 3100 N KINGS HIGHWAY
Zip Code: 34951 Fax: City: FORT PIERCE State: FL
Phone No. 772-252-4864 Zip Code: 34951 Fax: 772-794-1590
E-Mail: gmwaltz@yahoo.com Phone No 772-794-1581
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
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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 OUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee Contractor as Agent for Owner Signature of ntractor/License older
STATE OF FLORIDAc`� STATE OF FLORIDA Ly CA v,COUNTY OF s �� COUNTY OF
The forgoing instrument was acknowledged before me Thef rgoing instrument was acknowledged before me
this a day of V�q� 20aZ by this V day of Y`no.< 201!6 by
%,\,.\v-,,q qq.\ -� -'�'4" '\'d.6 S-., %'\`i�\b vvN J a,,, C'q 3s�
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced �� L
(Signature of Notary P lic-State of Florida) (Signature of 0§5 6 ,clic-Stat� f•1EFb?i `a
Commission No.,6 (Seal) . iiiss� N -
REVIEWS FRONT ZONI(at ,,�F:t SUP �Q �l C°`� r}�d ��i. ETATION SEA TURTLE MANGROVE
COUNTER REVD,,A,._°' �tEVfV'fNN REVIEW REVIEW REVIEW
DATE
RECEIVED "�\ .�•:°'�-
DATE
COMPLETED
Rev.