HomeMy WebLinkAboutBuilding Permit AppAll 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
ON:
Address: R \ \C�
Property Tax ID #: \�J &-A v -( C)pGjA' OcUG % Lot No. �t
Site Plan Name: Block No.
Project Name: -\a pc\eS VQOa 2yrC
INSTALLATION OF ( \ ) HURRICANE ACCORDION SHUTTERS
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:
Cost of Construction: $ ! 0
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE-
CONTRACTOR:
Name Jahn;,, 'V,, L; -gyp
Name: SAMUEL ZAZA
Address: 1119
Company:JUST SHUTTER IT
City: ST LUCIE State:I,
Zip Code:(, Fax:
Phone No.
Address: 515 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:.—
Phone N0772-201-9919
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailJUSTSHUTTERIT@GMAIL.COM
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.
yNot
DESIGNER/ENGINEER: xxx Applicable
MORTGAGE COMPANY. 10 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 to do the work installation
permit and 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 THEOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR TICE OF COMMENCEMENT."
f
Signature o Owner ssee/Contrac o as Agent for Owner
Signature of ontractor/Licens older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSTLUCIE
COUNTY OFSTLUaE
The forgoing instrument was acknowledged before me
`1
The forgoing instrument was acknowledged before me
this day of 2020by
this `—Aday of 'M Q,20' 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 Identification
Type of Identification
Produced
BF
Produced
(Signa re of Notary Public- e of Florida)
pu"e
(Signator of otary Public- State of a
ptOky ALYSSA A.T. BOWSER
Co mission No. GG 295930 *; (647mmission#GG 295930
°r
o"AyP`Bi, ALYSSA A.T, BOWSER
Comm' sion No. cc2sss3o • ° � �,
tsslon # GG 295930
0 Expires January 28, 2023
*
OFFLOP Bonded Thru Budget Notary Services
�"S"*_ p4 Expires January 28, 2023
lF CP
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19