HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: AUGUST 17, 2020 Permit Number: 4? Lqo I —0 030
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR:HURRICANE SHU. TTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 5406 PALEO PINES CIRCLE, FT. PIERCE, FL 34951
Property Tax ID #: 1312-801-0078-000-7
Site Plan Name: ZASH
Project Name: ZASH
DETAILED DESCRIPTION OF WORK:
INSTALL ELEVEN (11) HURRICANE ACCORDION SHUTTERS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.275
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping 'X Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 7,252.05
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TONY ZASH
Name: MIRIAN VAN TASSEL
Address:5406 PALEO PINES CIRCLE
Company: DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE Stater
Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax:
City: FT. PIERCE State -FL
Phone No. 772-205-5104
Zip Code: 34951 Fax: 772 794 1590
E-Mail:
Phone No772 794 1581
Fill in fee simple Title Holder on next page ( if different
E-Mail DVTH URRICAN ES H UTTERS I NC@HOTMAIL.COM
State or County License24394
from the Owner listed above)
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:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
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: 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 attornev before commencinig work or recording vour Notice of Commencement.
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Signature o Owner/ Lessee/Contractor as Agent for Owner
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STATE OF FLORIDA C�_
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STATE OF FLORIDA S �'
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COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
-Physical Presence or Online Notarization !
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Name of person making statement.
Name of person making statement.
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Personally Known Produced Identification
Personally KnownOR Produced Identification
Type of Identification
Type of Identification
Produced
Produced "�� ian Sue Blume
avian Sue Blum
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(Signature of Notary Pubf ' or
*ES: April 29
(Signature of Notary P" ' __if F pril 29, 2023
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Commission No. �� ��""Thru Aaron iota
Commission No. (Seal)
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