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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 7705 Holopaw Ave
Legal Description: LAKEWOOD PARK -UNIT 5- BLK 45 LOT16 (MAP 13/11 N) (OR 3881-2315)
Property Tax ID #: 1301-605-0138-000-0
Lot No.
Site Plan Name: Block No.
Project Name: Ryan K Eggers
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: j
—J
INSTALLATION OF HURRICANE SHUTTERS
CONSTRUCTION INFORMATION:
orme un er t Is pm erit — c ec a app y:
Additional work to ffGasTank
�HVAC �
❑Gas Piping Shutters ❑ Windows/Doors
Electric 1i Plumbing Sprinklers In Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3,458.62 Utilities: Sewer Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name Ryan K. Eggers
Name: Robert McNally
Address: 7705 Holopaw Ave
Company: Palm Coast Shutters & Aluminum Products. Inc.
City: Fort Pierce State: FL
Address: 675 4th St.
Zip Code: 34951 Fax:
City: Vero Beach State: FL
Phone No.
Zip Code: 32962 Fax: 772-299-1958
E-Mail:
Phone No. 772-299-1955
Fill in fee simple Title Holder on next page ( if different
E-Mail: Giovanna(a�palmcoastshutters.com
State or County License: CBC1262166
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: N/A
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
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.
which is in conflict with noapplicablelHome aOwnners Asssong ciat onlruleswill aby bylaws or andpcovenanholder
s thatmaymaydthe restr ctborproh bits structure
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender an att y before
commencingwork or recordingour Notice of Commencem
Sigrfature of w Lessee/Contractor as Agent for Owner
Ignature of Contractor/ icense Hol er
STATE OF FLORIDA
COUNTY OF 7' L)e
STATE OF FLORIDA
COUNTY OF INDIAN RIVER C Ty
The forgoing instrument was acknowledged before me
this 7 day of 20,Z�)by
The forgoing instrument was acknowledged before me
this 30 day of 20 20 by
Ryan K Eggers
ROBERT MC NALLY
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced F Z_ (� L u 2Q_ }
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
Notary Public State of Florida
Commis Giovanna prausal ��P
Ex o GG 287!)88a1)
ar Expires Ot /2gl2023
at re of N
1 f Florida
Notary Public StGG
Commission No. Giovanna Draal)
7
y es 01 r I228 098Expires O1128l2
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17