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All APPLICABLE
yy INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. 3-�'l- f;� (J Permit Number: 'd b ��0o �
Building Permit Applicatl� �
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
PERMITTYPE: SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 2700 HIGHWAY A1A FS FORT PIERCE, FL 34949
Property Tax ID#: 1425-704-0110-000-3' Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL 1 ROLL SHUTTER
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: $ 1,976.00 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name KENNETH DAVIDSON Name:THOMAS L PEASE
Address:2700 HIGHWAY A1A FS Company:FLORIDA SHUTTERS INC
City: FORT PIERCE State: FL Address:1055 COMMERCE AVE
Zip Code: 34949 Fax: City: VERO BEACH State:FL
Phone No.574-453-7777 Zip Code: 32960 Fax: 772-567-3674
E-Mail:kend1940@hotmail.com Phone No 772-569-2200
Fill in fee simple Title Holder on next page(if different E-Mail daniela@floridashuttersinc.com
from the Owner listed above) State or County License CBC 015453
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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF M NCEMENT."
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Signatu a Sf 6wn'er/Lessee/ ontractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDASTATE OF FLO IDA
COUNTY OF 1,,�kL� n � `�� COUNTY OF ��
The foUng instr ent was acknowledged before me The ffo ing instrNment was acknowledged before me
this Ir day of 0_J– .�r 20�o by this -Aday of a oV1. 20 ZD by
rll r)(MCA s C' Pea Sc o sL
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known !X— OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of FI rida ) (Signature of Notary Public-State
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Commission No. 1a37Z I "Y 10" '�21
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REVIEWS FRONT ZONING VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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