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All APPLICAB E IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: aQ
Permit Number:
O
Planning and Development Services Building Permit Application
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982 Residential X
Phone: (772) 462-1553 Fax: (772) 462-1578
P' MITAPpLICATION FOR:
Hurricane Shutters
PROPOSED IMPROVEMENT LOCATION:
Address: 9439 S Ocean Drive #5C
Property Tax I D 4: 3535-334-0003-190-7
Site Plan Name:
Project Name: Rauh
DETAILED DESCRIPTION OF WORK:
Install 6 Accordion Shutters
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit —check all that apply:
_Mechanical T Gas Tank —Gas Piping Shutters Windows/Doors Pond
_ Electric _ Plumbing — Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 5150.00
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameE:ileen D Rauh
Name: John Zervopoulos
Address:9439 S Ocean Drive #5C
Company: Advanced Hurricane Protection
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 772-229-2707
Address:4517 SE Commerce Ave
City: Stuart State: FL
Zip Code: Fax:
Phone N0772-220-1200
E-Mail:jackndeer@comcast.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail John@AdvancedHurricane.net
State or County License CBC1259339
it value or consuucuon is csuu or more, a KtWKULL) 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: TAddress:
GE COMPANY:
Address:
City; State; Zip: Phone Phone:
FEE SIMPLE TITLE HOLDER:
Not Applicable BONDING COMPANY:
Name:
Address:
Name:
City:
Address:
Zip:
City:
_Phone:
Zip: Phone:
Not Applicable
State:
—Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that noworkor installation has commenced prior to the issuance of a permit,
which is inoconflict with any applicable {Home at is Owners Association ciationfru es,authorize
by bylaws or andpcovenants that may restrict o1rp structure
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 attor before commencin work or recordin our Notice of cement,
'I U / Levee/Contractor as Agent for Owner Signatof Co ctor/Li ense Holder
RRIDA STATE OF FLORIDA
O F Martin
COUNTY OFMartin
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this 91h day of June 2020 by
John Zervopoleus
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
Notary
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this 9th day of June , 2020 by
John zer opoulas
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
(Signaturd of Notary Public- _ F r'
�r aU Notary pudic State of Fioru3a
Commission No, GG1333 a° �� M lar'y S�Ic Stadt
7 71X]R
Jc State of Florida
My Commission GG 133395 Commission No. EvvoldtExpires 08i101?.021sion GG 133395
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