HomeMy WebLinkAbout9107 Champions Way Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE:SHUTTER
Address: C110-1
Th r
Property Tax ID #:L�--
Permit Number:
Building Permit Application
Commercial Residential xxx
Lot No.__
Site Plan Name: 1( Wit^ j ��; ho Block No. _
Project Name: 21Gll-)(�'I- )C1
INSTALLATION OF (
- RMAT1 N;
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping 2 Shutters
T Electric _ Plumbing _ Sprinklers Generator
Total Sq. Ft of Construction:
Cost of Construction: $ A.,
Name �— inert ljk--)) k"Q
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic
Address: qlbl 0 V\1'U1 Cly WaC 'i
City: ST LUCIE State: 'FL_
Zip Code: 3L( �: i CG, Fax:
Phone No.
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Windows/Doors
— Roof Pitch
Building Height:
Name: SAMUEL ZAZA
Company:JUST SHUTTER IT
Address:515 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax:
Phone No 772-201-9919
E -Mail JUSTSHUTTERIT@GMAIL.COM
State or County License24293
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.
SUQI�Lf=�tIE��`AL C�NSTRUCTf.C3N LIEN f_AW 1NFaRMATf�N
DESIGNER/ENGINEER: xxx Not Alicable � �' ' '
pP
— MORTGAGE COMPANY: Not Appllcable
Name: Name:
Address: Address:
City: State: City: StatE!:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:Not Applicable
BONDING COMPANY: Not Appliaible
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 YOUR
PAYING
TWICE FOR IMOVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON' E JOB SITE BEFORE THE FIRST INSPECTION. IF YOU I TEND TO OBTAIN FINANCING, CONSULT
WITH YOUR NDER OR AN ATTORNEX BPF0W1WQ0RDING YOUR N ICE OF COMMENCEMENT."
re of Owne essee/Cott etor as Agent for Owner
i ature of Co -tor/Lice se [der
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSTLUCIE
COUNTY OFSTLUCIE
The for oing instrument was acknowledged before me
this 1day of [�(?,-I 2020
The forgoing instrument was acknowledged before me
by
this -2,_ day of OCI t 20 Zo by
SAMUEL ZAZA
SAMUEL ZAZA
Name of person making statement.
Name of person making statement.
Person no xxx OR Produced Identification
Type f Identifica ion
Personally Kno xxx OR Produced Identification
Type of Id tificat[
Pro ced
Produce
(Signature of Notary Public- State of Florida)
v Pis
(Signature of Notary Public- State of Florida )
Pq ALYSSA ATBOWSER
= o
ALYSSA A.T. BOWSE
GG 295930 mmission # GG 295930
Commission No. * �jp
(Sea !
N� o� Expires January 28, 2023
9TFOFF�oP�
01pRY�PUe(/c
= • # GG 29593
Commission No. GG 295930 (Se&i mmiSSlOri
xplresJarivary28,202
BondedThruBudgetNotarySerkea
N�9 \Qe
OFF�6P Bonded ThruBudget Notary Servi
e
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.