HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. A4`r`� �� 2020 Permit Number:
- ;J,_
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
PERMITTYPE: HURRICANE SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 673 PONYTAIL LANE, FORT PIERCE, FL 34982
Property Tax ID #: 3410-503-0168-000-7
Site Plan Name: LORI CHASE
Project Name: LORI CHASE
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF EIGHT�a ACCORDION HURRICANE SHUTTERS
CONSTRUCTION INFORMATION:
Lot No. 31
Block No.
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:
Cost of Construction: $ 7,981.00
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LORI A CHASE
Address: 673 PONYTAIL LANE
City: FORT PIERCEState: LL
Zip Code: 34982 Fax:
Phone No. 401-378-2694
Name: MIRIAM VAN TASSEL
Company: DVT HURRICANE SHUTTERS, INC
Address: 3100 N KINGS HIGHWAY
City: FORT PIERCE State: FL
Zip Code: 34951 Fax: 772-794-1590
Phone No 772-794-1581
E -Mail: Harley.chase@me.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail dvthurricaneshuttersinc@hotmail.com
State or County License 24394
If value of construction is 52500 or more, a RECORDED Notice of Commencement is requirea.
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
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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 thepermit 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 COMMENCEMENT."
re of Owner/ Lessee/Contractor as Agent for Owner I Signature of gbntractor/License Holder
STATE OF FLORIDA I�/ STATE OF FLORIDA /
COUNTY OF ,/e,-1cCA—v COUNTY OF S7`t
The forgoing instrument was acknowledged before me
this day of �j 202/9%by
Name of person making statement.
Personally Known R Produced Identification
Type of Identification
Produced
(Signature of Notary PPublicc- State of Florida
Q )
Commission No. v °C-` ,ul &' (Seal)
Vivian Sue Blul
REVIEWS FRONT
NTER %;al pX
COU
DATE
RECEIVED
DATE
COMPLETED
The forgoing instrum nt was acknowledg��j,d efore me
this 4- day of 20G y
a/ rI x Y>//
Name of person making statement.
Personally Known 11--�OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- State of/Florida )
Commission No. 1SIf 1Jl(Seal)
,.I _,; Vivian Sue B
LANS VEGETATION
VIEW REVIEW