HomeMy WebLinkAboutBuilding Permit Application v
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /� n�
Date: Permit Number: fJ ukJ Ua�0
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Building Permit Application
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 X
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION.: '
Address: 10909 S Indian River Dr.
Legal Description: B S Harris S/D Blk 4 Lots 1 and 2
Property Tax ID#: 3532-503-0048-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Riber Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
, 7,sf Ala -y 6e.cOtiD ; o,v .SA O �s
CONSTRUCTION INFORMATION:
Additional work to e nerformed under this permit—check,a apply:
11HVAC0 Gas Tank Gas Piping Shutters Q Windows/Doors
Electric Plumbing OSprinklers E]Generator 11Roof '.Roof pitch
Total Sq. Ft of Construction: G+ S Ft.of First Floor.:
Cost of Construction:$ -�3`�o Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR".-
Name Thomas&Laurie Riber Name: Edward-J=Heritage'-'
Address:10909.S,Indian,River Dr,,,,, Company:.,Folding Sh'utte,_Corporation
City: Fort Pierce.- State:F� Address;. 1862'DCMartin_Luthe�__I<ing-Blvd
Zip Code: 34982. Faz "'- City: West4Palm'Beacfi' State:FL
Phone No:T-72-485=0061r,;.- Zip Code: 33404 Fax: 561-640-8204
E-Mail: Phone No. 561-683-4811
Fill in free simple Title Holder on next page(if different E-Mail: info@foldingshutters.com
from the Owner listed above) State or County License: SCC131151041•
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
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Signature of Owner ss ctor as Agent,for Owner Signature of Con �icese iipr
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The for oing instrument w4s acknowledged before me The for$Ding instrument was acknowledged before me
this 2 day of /tilt 20��by this `X day of AtA cfl 20 RD by
EDWARD J HERITAGE EDWARD J HERITAGE
(Na erson acknowledging) (Name erson acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
ot�R AA a
o NOT PUBLIC
Commission No. Ql) o.Commission N Seal)
+STAY FLORIDA Pamela Pea
o!o Ass�o NOTARY PUBLIC
Comm#GG262789
S�kCE 19� Expires 10111 oWrP
FLORIDA
Revised 07/15/2014 Comm#GG262789
s Expires 10/11/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS