HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
Date: la— L{i�L� Permit Number: �� 1�f _'A (2 / I
RECEIVED
• DEC .0.4 2019
Building Permit Application permitting Department
Planning and Development Services St. Lucie Cc, ot�
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE: Hurricane shutters
PROPOSED IMPROVEMENT LOCATION: ----
Address: 5409 S Indian River Dr. Fort i
Property Tax ID #: 3401-604-0003-000-5
Site Plan Name:
Project Name: Hurricane shutters
FL 34982
Lot No.1
Block No.
-DETAILED DESCRIPTION OF WORK:- - ,. "; _, .. _ _ __ _.., . _, .... _......_.
20 accordions and 2 manual roll -ups.
'CONSTRUCTION'INFORMATION
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping D Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —
Cost ofConstruction:$ 12,000.00 Utilities: _Sewer _Septic
—Windows/Doors
Roof Pitch
Building Height: 25 feet
..OWNER/LESSEE:-.- '_ .. _ _--' .. . _. _ .. -
_CONTRACTOR. _--._
Name Ian Boykin
Name:Edwing Sosa
Address:•5409 S Indian River Dr.
company:Edwing's Unlimited Shutter Services LLC.
Address: PO Box 881085
City: Fort Pierce, Florida State:_
Zip Code: 34982 Fax:
Phone No.772-528-2647
City: Port St. Lucie State: FL.
zip Code: 34988-1085 Fax: (772) 905-9431
Phone No(772) 370-0766
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mailed@edsunlimitedserviceS.com
State or County License28457
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.
I'SUPPLtMENTAL CONSTRUCTION LIEN'LAW INFORMATION:
Name:
City:
Zip:_
Phone
State:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Address:
City:
Zip:
Phone:
X Not Applicable
BONDING COMPANY: X Not Applicable
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVTT: 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FOIST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OgAWATrORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Si essee/Contractor as Agent for Owner
Signature of Cont ctor/Ucense Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ST. LUCIE
COUNTY OF ST. LUCIE
The forgoing instent was acknowledged before me
rL�rp
The forgoing instrument was acknowledged before me
this �.l day(�of DY4_w,bsr 2011L by
thisI]_dayof �o��. he—.2010 by
1 LA n 00 Y1.1
�oS�—
Name of person aking statement.
Name of person ma " statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification ✓
Type of Identification
Type of Ide till tion
Produced �1 •
Produced :�
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(Signature of Notar �' - 0p 1 C. 0.-OY 8
's�'R •i° CommA IOn 1!:fF96Y832
(S• atu P lic-Stet
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Commission No. A' r1
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Commission No.
Notary Public -State of Fig
CommisslonWGG138318
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Rev.z/7/19