HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FO-R APPLICATION TO BE ACCEPTED
Date: July 10, 2020 Permit Number: OS-T
�0 WC IE ,
Q 1
V 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:
Residential X
'Address: 5215 FEATHER CREEK DR FORT PIERCE, FL 34951
1312-801-0227-000-7 424
�Property Tax ID #: Lot No.
Site Plan Name: Block No.
;Project Name:
11 -DETAILED DESCRIPTION OF WORK:
We will install twelve (12) 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 A Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 9,448.31
_ Generator
Sq. Ft. of First Floor:
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name MARIA CLAYTON
Address:5215 FEATHER CREEK DR
Name: MIRIAM VAN TASSEL
Company: DVT HURRICANE SHUTTERS
City: FT. PIERCE State: Re
Zip Code: 34951 Fax:
Phone No. 772 353 7215
E-Mail:
Address: 3100 N. KINGS HIGHWAY
City: FORT PIERCE State: FL
Zip Code: 34951 Fax: 772 794 1590
Phone No772 794 1581
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:
City: State:
Zip: Phone
MORTGAGE COMPANY:
Name:
Address:
Citv:
Zip: Phone:.
Not Applicable
State:
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 permit to do the work and installation as indicated.
11 certify that no work or installation has commenced prior to the issuance of a permit.
jSt. Lucie County makes no representation that isgranting 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.
of
as Agent for Owner
STATE OF FLORIDA I
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
�hysical Presence or Online Notarization
this '.?--:,day of2020 by
Name of person making statement.
Personally Known R Produced Identification
Type of Identification
Produce
(Signature of Notary P - - diplW_ FI� ' SSION # GG297t146
Commission No. Sae EX
P3RRS: April 29, 2023
Bonded Thiu Aaron Notary
Contractor/License Hol
STATE OF FLORIDA L '
COUNTY OF '5 - l- "'0_�
Sworn to (or affirmed) and subscribed before me of
--Physical Presence or Online Notarization
this '2�1ay of 2020 by
I
/ 1 1 G / Own I//a'm I CV- 1-sC' J
Name of person making statement.
Personally Known ---OR Produced Identification
Type of Identification
Produced
2)t .w -, Vivian Sue Blume
(Signature of Notary : li a Elf $SIGN #GG297846
�EXPI S: pol 29, 2023
Commission No. �'yF�`go"� Notary
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SUPERVISOR
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DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20