HomeMy WebLinkAboutBuilding permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
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 XXX
PERMITTYPE:SHUTTER
Address:
Property Tax ID #:
Site Plan Name:
Project Name: _
IN.qTAI I ATIr)N OP (
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping -AShutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 133 K
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Namel-�Wo'!1 HMO Or- �1 Name:SAMUEL ZAZA
Address. 13q 12(itVl� P i� I�i � 0 --- Company:JUST SHUTTER IT
City: ST LUCIE I U State: L Address:515 NW ENTERPRISE DR
Zip Code: (1/) — Fax: City: PORT ST LUCIE State: FL
Phone No. Zip Code: 34986 Fax:
E-Mail: Phone No772-201-9919
Fill in fee simple Title Holder on next page ( if different E-MailJUSTSHUTTERIT@GMAIL.COM
from the Owner listed above) State or County License24293
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: xxx Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
P Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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� ,, HE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH Y, R ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
r
Signature of Owner/ 1_0's ee/Contractor as Agent for Owner
Signature o ontractor icen older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFST LUCIE
COUNTY OFST LUCIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of MO YL l 2010 by
this day of Y�n_Cq 20,-1(2 by
SAMUEL ZAZA
SAMUEL ZAZA
Name of person making statement.
Name of person making statement.
Personally Known xxx OR Produced Identification
Personally Known xxx OR Produced Identification
Type of Identificption
Type of Identifiq, ion
Produced
Produced
(Signat re of Notary Public- State of Florida)
(Sig ature of Notary Public- State of Florida )
P01% ;?Ue,c ALYSSA A.T. BOWSER
oti►AY P�s�, ALYSSA A.T. BOWSER
Comm slon No. GG295930 * a ommission#GG29593
IPA�� Expires January 28, 2Q23Expires
GG295930
Commission No. * �Seaf1mmission#GG29593
January 28, 202
Fp jo Bonded Thru Budget Notary Sery
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Rev. 2/ // 19