HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: 2 00 �— 0 0 2 y
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 x Residential
PERMITTYPE:hurricane shutters (accordion type)
PRQPOSED IIVIPROV ff",LOCATIbN "' " ` ° `'� .�
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Address: 9650 S OCEAN DR 401, JENSEN BEACH FL. 34957,
Property Tax ID q: 4502-610-0031-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Joseph & Lorraine M Golden
3 accordion shutters at the balcony area
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping XShutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 11,141.00
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height: 160ft
OWNER/LESSEE' u'+ ,<i :t ^ , i ' rug"th rv' x rE
CONTRACTOR ` , u? ;=, t'Y 4s°u •'' tt,
NameJoseph, Lorraine, David & Somwang Golden
Address:9650 S OCEAN DR 401
Name:Edwing Sosa
company:Edwing's Unlimited Shutter Services LLC.
Address: PO Box 881085
city: JENSEN BEACH State: FL.
Zip Code: 34957 Fax:
Phone No.(732) 425-0361
city: Port St. Lucie State: FL.
Zip Code: 34988-1085 Fax: (772) 905-9431
Phone No(772) 370-0766
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail ed@edsunlimitedservices.com
State or County License28457
If value of construction is $2500 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.
SUPPLE MENTAL CONRUCN LIEN LAW INFORMATION'
.t STTIO, �.
DESIGNER/ENGINEER:
Name:
X Not Applicable
MORTGAGE COMPANY:
Name:
X Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
X Not Applicable
BONDING COMPANY:
Name:
X Not Applicable
Address:
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 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 THA JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
VMM YOUR ILdhFR DRAM ATIrORNET BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/ Lessee/ContractoriWAgent for Owner
Signature of C ntractor/License Holder
STATE OF FLORIDA
STATE OF LORIDA
COUNTY OF Si• Lk w c-
COUNTY OF—a2N,-
The forgoing instrument vv�as acknowledged before me
The forgoing instrument was acknowledged before me
this 15j day of M rt r ° h 20 U by
this � day of erne zr-c_, y-20'LA by
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To-re/thr L671r4inf, 14VIA, S6,,Wahq Co1dr 4.
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Nam of person making statement
Name of person m g statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification ✓
Type of Idenrfication
Type of Identificati
Produced ii •(
Produce �-
a.. � s�£4
(Signature of Notary Public- State of Florida
(Sigisfurot ry i
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Commission No. ?�;Ilotary Wdl7€adlate of Florida
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Commission No. t NotaryPu�Tje3)eofFlodda
Commission gGG 959255
CommisslonrGG135318
My Comm. Expires May 29, 2024
? MyCgnm.EAplresAug16,2021
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Rev. Z/7/19