HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date : Permit Number :
O
® Building Permit Application:
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone : ( 772 ) 462-1553 Fax : ( 772 ) 462 - 1578
PERMIT APPLICATION FOR .& Accordion Shutters
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Address : 337 NE Bracken Rd
Property Tax ID # : 3419-570-0124-000-2 Lot N0 . 4
Site Plan Name : Block No . 82
Project Name :
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Install two Accordion Shutters
New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit — check all that apply :
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq . Ft of Construction : Sq . Ft. of First Floor :
Cost of Construction : $ 3649 . 00 Utilities : _ Sewer _ Septic Building Height :
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NameKeneth Cahoon Name : Steven C Mears
IL
Addres5 . 337' NEP B`rdcken Rd Company: Lifetime E?zteriors
City : PSL' ± State : dAddress: '102 South F St
Zip Code: ' 34983 Fax : City : Lake Worth State : Fl
F Phone No . 401_-3o -i 4502 Zip Code : 334601 Fax : 561 -582-7505
E - Mail : Phone No561 -533-8700
Fill in fee simple Title Holder on next page ( if different & Mail Diane@Lifetimeexteriors . net
from the Owner listed above ) State or County License CGC1529442
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 .
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DESIGNER/ ENGINEER : Not Applicable MORTGAGE COMPANY : _ Not Applicable
Name : Name :
Address : Address :
City : State : City : State :
Zip : Phone Zip : Phone :
FEE SIMPLE TITLE HOLDER : _ Not Applicable BONDING COMPANY : Not Applicable
Name : 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 before commencing work or recording our Notice of Commencement .
X .,� �
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License older
STATE OF FLORIDA �� f STATE OF FLORIDA
COUNTY OF y COUNTY OF I'
Sworn to ( or affirmed ) and subscribed before me of Sworn to ( or affirmed ) and subscribed before me of
Physical Presence or X Online Notarization Physical Pre enc or X Online Notarization
this9cl day of`2* ,M , 2020 by this M day of 2020 by
,ne=Nn Cakelo n aver
Name of person" making statement . Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Prod ce
u o otary Pu ic- State o Florida ) ( Si a ur o Notary Public- State of FI i
^ °�' KRYSTAL D , BER S,€€yy, V'690 �' KRYSTAL D. BE NAmok
Commission Note �(0 ��5� Notary Public • State f �hiriclm Sion No. —i Co J(DNotary Public - Stalorida
+ Commission p G 2 56A•' Commission # GG 69656FK M Comm . Ex ire ••..,oFF� M Comm ct 1 2022
Bo ded through National otary Assn , onded through National o Jr6
Assn ,
REVIEWS FRONT ZO I VEGETATION SEA TU E PMATMMT
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev . 5/ 6/ 20