HomeMy WebLinkAboutPermit Application - Goukasov - 3880 N A1A Unit 104All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: q - n - 2ow Permit Number:
OIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIM
COUNTY.
F LORID/4,--.
11111111111.11111.111111.1111111. Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
IPhone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 3880 North AlA Unit 104, Hutchinson Island, FL 34949
Property Tax ID #: 1423-805-0062-000-5 Lot No.
Site Plan Name: Block No.
Project Name: Sergei Goukasov
DETAILED DESCRIPTION OF WORK:
Installation of Hurricane Protection
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical Gas Tank Gas Piping _Shutters Windows/Doors_ _ _
Electric Plumbing Sprinklers Generator Roof Pitch— _ —
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4,188.76 Utilities: Sewer _Septic Building Height:
OWNER/LESSEE:CONTRACTOR:
N ame Sergei Goukasov N ame: Robert Altino
Address:3880 North AlA Unit 104 Company: Galeforce Hurricane Shutters, Inc.
City: Hutchinson Island State: FL Address:1429 SE Village Green Drive
Zip Code: 34949 Fax: City: Port St. Lucie State:FL
Phone N o.772-216-7126 Zip Code: 34952 Fax:
E-Mail: oceanfrontliving@gmail.com Phone No 772-337-6200
Fill in fee simple Title Holder on next page ( if different E- m a iigaleforcetc@gmail.com
from the Owner listed above)State or County License CBC1251430
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:Not Applicable MORTGAGE COMPANY:
Name:
Not Applicable
Name:
Address:Address:
City:State:City:State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable BONDING COMPANY:
Name:
Not Applicable
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 structurewhich is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit suchstructure. 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 FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANONG, CONSULT
WITH YOUR LENDER..ORN ATTORNEY BEFORE RECORDING YOUR NOTICE 0 EMENT."
al°
S nature of Contractor/License Ho .
STATE OF FLORIDA
COUNTY OF EPIJ,IT: LUC i
4f!' reof Owner/ Lessee/Con r. . s Agent for Owner
STATE OF FLORIDA ,)
COUNTY OF I 1\)-i- 1----U C_ 1 E"
The forgoing instrument was acknowledged before me
this I "I day of Sp , 20 ZO by
_A-
The forgoing instrument was acknowledged before me
this il d ay of by r.-1-E,mixer::
RDIDer+ ALki n (2)
_Sta__?emile_c-202.1)
..-;D b P r—k— A- I 4:t no
Name of person making statement.
Personally Known / OR Produced Identification
Name of person making statement.
Personally Known 1 OR Produced Identification
Type of Identification
Produced
Type of Identification
Produced
4Jt au,_(Aa2t L
(Signature of Notary Public-S e of F81r6Wij symons Palle
61C13.0 LP b a * NOT ,IY PUBLIC
Commission No. — STATt Vtl#LORIDA
(Signature of Notary Pub ic- State of Florida)
&t(---t 3t4 7 4 c6.3 ' Gabrielle Symons Pohle
Commission No. ;.•.,, ' • NoyisoquBuc-- ...II:, - STATE OF FLORIDA
ii, '4 r.nmm# GG367483
_
* Comm# GG367483•
REVIEWS
.....•,-„,
FRONT
COUNTER
• _xpires 9/1212023
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
Expires 9/12/2023
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.