HomeMy WebLinkAboutBuilding permit application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �19- 7-D ZP) RECEIVED Permit Number: 1 6b i
SM ILUMM b- SEP $ 51010
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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:
HURRICANE SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 5503 MYRTLE DRIVE FT. PIERCE, FL 34982
Property Tax ID#. 3402-609-0087-000-5 Lot No.29
Site Plan Name: BURGESS Block No. 54
Project Name: BURGESS
DETAILED DESCRIPTION OF WORK:
INSTALL ONE (1) HURRICANE ACCORDION SHUTTER AND
ALUMINUM STORM PANELS FOR TWELVE (12) OPENINGS
New Electrical Meter Second Electrical Meter
[CONSTRUCTION INFORMATION:
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: $ 3,332.06 Utilities: —Sewer —Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name PAULETTE BURGESS Name: MIRIAN VAN TASSEL
Address: 5503 MYRTLE DRIVE Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State: EL Address:3100 N. KINGS HIGHWAY
Zip Code: 34982 Fax: City: FT. PIERCE State:FL
Phone No.772 461 4615 Zip Code: 34951 Fax: 772 794 1590
E-Mail: Phone No 772 794 1581
Fill in fee simple Title Holder on next page(if different E-Mail DVTHURRICANESHUTTERSINC@HOTMAIL.COM
from the Owner listed above) State or County License24394
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 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.
Signature f Owner/Lessee/Contractor as Agent for Owner Sig ure o Contractor/License Holder
STATE O�COUNTY OF— COUNTY
FLORIDA
S�- COUNTY OF
Sw�wto(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
./ Physical Presence or Online Notarization hP ysical Presence or Online Notarization
this 22day of 2020 by this 22day of 2020-by
n— t o.VY� (� �� l ( r r ae►'lam rn�n y �7
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 Produ erj
Vivian Sue Blume ��r/,y.,,, Vvian Sue Blume
uv r-,.�
(Signature of Notary @ytbli ataf (Signature of NotaryFibl' tof ar :A ril 29 2023
EXPIRES:April 29, 2023 %` ;�.. 1'I P
Commission No. ��' :.����'�� Bond �llru Aaron Notary Commission No. ��''��► ,au�`'° BOnde��gl)Aaron Notary
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW',
DATE
RECEIVED
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