HomeMy WebLinkAboutPermit Application - Ingram - 10309 Crosby PlaceAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Li2 2-14 -2-02-0
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: SHUTTERS
Permit Number:
Building Permit Application
Commercial Residential
PROPOSED IMPROVEMENT LOCATION:
Address. 10309 Crosby Place, Port St Lucie, FL 34986
Property Tax ID #: 3327-709-0056-000-6
Site Plan Name:
Project Name: Jeffrey Ingram
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Installation of Hurricane Protection
' CONSTRUCTION INFORMATION:
Additional work to be performed under this permit - check all that apply:
Mechanical
Electric
Total Sq. Ft of Construction:
Gas Tank
Plumbing
Gas Piping
Cost of Construction: S 6,359.17
Sprinklers
Shutters Windows/Doors
Generator Roof
Sq. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
Pitch
OWNER/LESSEE:
NameJeffrey Ingram
Address:10309 Crosby Place
City. Port St Lucie
Zip Code: 34986 Fax:
Phone N o.678-641-3141
State: FL
jvingram4@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
N a me: Robert Altino
Company: Galeforce Hurricane Shutters Inc
Address:1429 SE Villiage Green Drive
City: Port St. Lucie
Zip Code: 34952
Phone No 772-337-6200
Emaiigaleforcetc@gmail.com
State or County License CBC1251430
Fax:
State:FL
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:Not Applicable MORTGAGE COMPANY:
Name:
Not Applicable
Name:
Address:Address:
City:State:City:State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable BONDING COMPANY:
Name:
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 tne work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
Tne following building permit applications are exempt from undergoing a full concurrency review: room acditions,
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 No-ncE OF COMMENCEMENT."
Signature of Owner see/Contra or as Agent for Owner
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this 24cay of _,314,r‘.410 , 20 2E> by
e-r nb
Name of person mak ng statement.
Personally Known V OR Produced Identification
Type of Identification
Produced
4.)
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NOTARY PUBLIC
ommission No. (W.111).ORIDA
REVIEWS FRONT
COUNTER
Comm# GG367483
Ex/sites 6i/1'iOn9q
ZONING
REVIEW
SUPERVISOR
REVIEW
Sign actor/License
STATE OF FLORIDA(—
COUNTY OF
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The torqoing instrument was acknowledged before me
this 2a day of ataans , 20 217by
A-141 vli›.
Name of person making statement.
Personally Known OR Produced Identificiit ,w7
Type of Identification
Produced
(Signature of Notan‘Albibio
Commission No.
PLANS
REVIEW
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itifelSymote PoNe
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TATE OF FLCRICDIA
Comma GG367483""""°—
Expires 9/12/2023
VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEWREVIEW
DATE
RECEIVED
DATE
COMPLETED
2/7710