HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application OCT p 6
Planning and Development Services
ST. ie County, Permitting
Building and Code Regulation Division Commercial Reside
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: S�vie i'S
PROPOSED IMPROVEMENT LOCATION:
Address: 7807 EDEN RD. FT. PIERCE, FL 34951
Property Tax ID#: 1301-603-0223-000-7 Lot No.21
Site Plan Name: ROUSE Block No. 24
Project Name: ROUSE
DETAILED DESCRIPTION OF WORK:
INSTALL TWO (2) BAHAMA SHUTTERS
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:$ 1,003.02 Utilities: —Sewer _Septic Building Height:
,OWNER/LESSEE: CONTRACTOR:
Name JAMES ROUSE Name: MIRIAN VAN TASSEL
Address:7807 EDEN RD. Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State: P'k- Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax: City: FT. PIERCE State:FL
Phone No.772 563 3185 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-MailDVTHURRICANESHUTTERSINC@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 thepermit 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 recor
4ingour Notice of Commencement.
Signatur of Owner/Lessee/Contractor as Agent for Owner Signat re of Co tractor/L ense Holder
STATE OF FLORIDA ( STATE OF FLORIDA
COUNTY OF S� �� 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 Physical Presence or Online Notarization
this_�day of c!� 2020 by this day of C) 2020 by
Name of person making statement. Name of person making statement.
Personally Known Produced Identification Personally Known `/ OR Produced Identification
Type of Identification Type of Identification
Pro ed Prod c(Zd
0 Vivian Sue Blume 1�V�f Vi ian Sue Blume
(Signature of Notarj ub S t£o (Signature of NAVlic*fta e )
EXPIRES:April 29, 2023 W01111
EXPIRES:April 29, 2023
' ffBonded
Commission No. '�: a Bondef�t= Aaron Notary Commission No. ��i�, , Thi Notr:ry
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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