HomeMy WebLinkAboutSt Lucie Building Permit Application_00000ALL 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: 5743 Sunberry CIR
PORTOFINO SHORES -PHASE TWO- (PB 43-33) LOT 442 (OR 3091-2969: 3838-1927)
Legal Description
Property Tax ID #: 1312-502-0192-000-4
Site Plan Name:
Project Name: Thomas R LaDuc
Setbacks Front Back:
Right Side
Left Side:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: j
INSTALLATION OF HURRICANE SHUTTERS
CONSTRUCTION INFORMATION:
CONTRACTOR:
Name Thomas R LaDuc
Name: Robert McNally
Itiona wor to e e orme under this permit— check
❑HVAC E] []Gas Piping
a
�
appy:
Shutters
❑ Windows/Doors
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Gas Tank
11 Electric ❑ Plumbing
❑Sprinklers
❑ Generator
❑ Roof Roof pitch
Total Sq. Ft of Construction:
S. of First Floor:
Cost of Construction: $ 3,458.62
Utilities1lSewer
❑Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Thomas R LaDuc
Name: Robert McNally
Address: 5743 Sunberry CIR
Company: Palm Coast Shutters & Aluminum Products, Inc.
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No.
Address: 675 4th St.
City: Vero Beach State: FL
Zip Code: 32962 Fax: 772-299-1958
Phone No. 772-299-1955
E -Mail: Giovanna(@-palmcoastshutters.com
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CBC1262166
If value of construction is 52500 or more, a RECORDED Notice of Commencement is requirea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: N/A
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:
City:
Zip: Phone:
Address:
City:
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: rA
re to Record a Notice of Commencement may result in your paying twice for
improvements to your proA Notice of Commencement must be recorded and posted on the jobsite
before the inspection. Iintend to obtain financing, consult with lender or an attorney before
commen I2 k or recorour Notice of Commencement. l
Sign ure of Owne r ctor as Agent for Owner
Signature of Contracto Li nse o r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF i�o�/teny,e�/
COUNTY OF INDIAN RIVER COUNTY
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this '6' day of y,6GuZ% 20ZIC;by
this ,L day of Jeal }D ! , 20 20 by
Thomas R LaDuc
ROBERT MC NALLY
Name of person mag statement
Name of person making statement
Personally Known 4/OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Produced
Prod
(Sig atNor U It - t
ot�ry Public State of Far
(Signature Notary ublic- State of Florida )
.r�PP a
CO (S I)
9875
Com I Notary Public State of Flor4a ( al)
-Giovanna rause
a n xptoo 9�2
My Commission GG 287096
Ta,
^ Expires 01/2612023
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Rev. 8/2/17