HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
COUNTY
`' ` _ ` . Building Permit Application
(NAR 2 41010 �
Planning and Development Services Ppr IWng Department
Building and Code Regulation Division St.Luc1e County
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:
28 La Puerta del Norte, Fort Pierce, FL 34951
PropertyTax ID#: 1301-500-0571-000-5 Lot No. 28
Site Plan Name: JAMES BROOKS Block No.
Project Name: JAMES BROOKS
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DETAILED DESCRIPTION OF WORK:
INSTALLATION OF SIX (6)ACCORDION HURRICANE SHUTTERS
AND ONE (1) NAUTILUS ROLLING SHUTTER (HAND OPERATED)
FI
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply::
_Mechanical _Gas Tank _Gas Piping �ztters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 4,315.64 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR: i
Name JAMES BROOKS Name: MIRIAM VAN TASSEL
Address: 28 La Puerta Del Norte 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. 772-465-7325 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 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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicabi,e
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as iniicated.
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 struct lure
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, j
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."
Signatu a of Owner/Lessee/Contractor as Agent for Owner Signature Contractor/License Holder
STATE OF FLORIDA ii STATE OF FLORIDA
COUNTY OF T- COUNTY OF A-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this, LI day of 20 by this�day of 20?'O by
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
O M�
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
/� �y4' ' ,, Vivian Su Blume
� (G l78�f�� V )
Commission No.GG2-97� �/ic�'" Ckuion No. Z ``�•i eal Vivian,Su@
COMM
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rop 911191
9y COMMI 7846
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� ISOR P�1Q5' I 9 2023
VEGETATION SE� 3 .�`
COUNTER REVIEW REVIEW REVIEW REVIEW RENEW tart
DATE
RECEIVED
DATE
COMPLETED
iev.2/7/19