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 x Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 6030 Indrio Rd. # 06
Legal Description: INDIAN PINES VILLAGE- BLDG 0 UNIT 6 AND PRO -RATA SHARE IN COMMON ELEMENTS (OR 1635-1230)
Property Tax ID #: 1313-501-0108-000-9 Lot No._
Site Plan Name: Block No.
Project Name: Cornelius, Robert
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF HURRICANE SHUTTERS
CONSTRUCTION INFORMATION:
Additional work to be 6ze orme un er t Is permit — c ec a appy:
HVAC Gas Tank ❑Gas Piping ✓ Shutters Q Windows/Doors
Electric ❑ Plumbing Sprinklers Ei Generator 0 Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2,031.31
Scn of First Floor: _
Utilities: Sewer Septic
OWNER/LESSEE:
Name Cornelius, Robert
Address: 6030 Indrio Rd. #06
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Building Height:
Name: Robert McNally
Company: Palm Coast Shutters & Aluminum Products Inc.
Address: 675 4th St.
City: Vero Beach State: FL
Zip Code: 32962 Fax: 772-299-1958
Phone No. 772-299-1955
E -Mail: Giovanna[a-)paImcoastshutters. com
State or County License: CBC1262166
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: N/A
_
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNFR/ rnNTRerTnQ eccinvir. __
-- — — . • ANN I'_dL1U a nereoy mane to obtain a permit to do the work and installation as indicated.
I certify that no y work or installation has commenced prior to the issuance of a permit..
St. Lucie
kes
which is noconflictaw with aony applicablelon Ho eaOls granting a wnners Association lt will authorize rules, bylaws or and covenantermit s that mayer to dthe restr restrict subject structure 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
JAL
Signature of Owner/ Lessee/ ontractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 7j�/�/,9tij/ ('�' COUNTY OF INDIAN RIVER COUNTY
The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before
this 4�¢day
�ojf �I ell 20D0 by this � day of d :1 20 by /
06 er l` a y, ROBERT MC NAL Y l L ��
Name of person making statement Name of person making statemen
Personally Known L OR Produced Identification Personally Known X OR Produced Id ification
Type of Identification
Produced Type of Identification
Produced
(Signa 0 otarw�I 4toGtR(Wft )
Signat a ar�Povar`'� i on a )
�P Giovanna Drausal Giovonna r
COmmi i My Comm�sslon GG 28709&eal)y Comm�sson • r 287096
a xP e?tpbh?g23 lt�' Comm,Co�a Ex�Ires o�� 4f7: t (Sea
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
DATE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
tev.8/2/17