HomeMy WebLinkAboutAPPLICATION LUTZAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f r
Date: May 27, 2020 Permit Number:
t LUc-LL
` Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Hurricane Shutters
PROPOSED IMPROVEMENT LOCATION:
Address: 9431 MEADOWBROOK DRIVE, FORT PIERCE, FL 34951
Property Tax ID #: 1327-801-0092-000-7
Site Plan Name: LUTZ
Project Name: LUTZ
DETAILED DESCRIPTION OF WORK:
We will install five (5) accordion hurricane shutters.
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
_Mechanical _ Gas Tank —Gas Piping X Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ J D, /-/
02. 0 0
Generator
Sq. Ft. of First Floor:
Residential X
Lot No. 286
Block No.
Windows/Doors _ Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name JOHN LUTZ
Address: 9431 MEADOWBROOK DRIVE
Name: MIRIAM VAN TASSEL
Company: DVT HURRICANE SHUTTERS ,T416
City: FT. PIERCE State:%.
Zip Code: 34951 Fax:
Phone No. 470 215 3314
Address: 3100 N. KINGS HIGHWAY
City: FORT PIERCE State: FL
Zip Code: 34951 Fax: 772 794 1590
Phone No772 794 1581
E -Mail: johndlutz04@aol.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 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
Rev. 5/6/20
Signature of O ner/ Lessee/Con actor as Agent for Owner
Signature of Cont r for/License Holder
STATE OF FLORIDA
COUNTY OF �'-`-��
STATE OF FLORIDA
COUNTY OF
Sworn t (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
this day of 2020 by
Swo to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this '- -tday of 2020 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
Prodd
v vm Vivian Sue Blume
(Signature of Notary _ li of 297816
' . EXP�ISReE§j: April 29, 2023
Commission No. ''�, •• .�` Bonimi lft Aaron Notary
V an Sue Blume
V ���
(Signature of Notary P3al�lic tefc F� d�s: April 29, 2023
�,, ' We
Commission No. �,n A2r09t Nom
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20