HomeMy WebLinkAboutBasty Permit AppAll APPLICAB E INFP MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� Permit Number:
� o � _l �
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Accordion Shutters
PROPOSED IMPROVEMENT LOCATION:
Address: 21 Lake Vista Tri #102, Port St. Lucie, FL 34952
Property Tax ID #: 3422-500-0282-000-0
Site Plan Name:
Project Name: Basty
DETAILED DESCRIPTION OF WORK:
Install 3 Accordion 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 %/ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2725.00
Generator
Sq. Ft. of First Floor:
X
Lot No.�
Block No.
Windows/Doors _ Pond
_ Roof Pitch
Utilities: —Sewer _ Septic. Building Height:
OWNER/LESSEE;
CONTRACTOR:
Name Antonia Basty
Name: John Zervopoulos
Address: 21 Lake Vista Trl #102
Company: Advanced Hurricane Protection
City: Port St. Lucie State:
Zip Code: 34952 Fax:
Phone No. 772-342-8240
Address: 4517 SE Commerce Ave
City: Stuart State: FL
Zip Code: 34997 fax: NIA
Phone No 772-220-1200
E -Mail: stetonl@yahoo.com
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
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:
i
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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.
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 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 b0sre commencing work or recording vour Notice of Commencement.
Signa e of Own ssee/Contractor as Agent for Owner Signature o ontrac ense Holder
ST TE A STATE OrFCORIDA
COUNTY OF M.rlln COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization x Physical Presence or Online Notarization
this 19th day of August 2424 by this 19th day of Au9..t 2424 by
Jahn Zervopoulos John zervopoulos
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced
rept !Votary Public -
Commission No. GG133395
REVIEWS FRONT
COUNTER
DATE
RECEIVED
COMPLETED
Personally Known x OR Produced Identification
Type of Identification
Produced
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SUPERVISOR
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