HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: Shutter
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Address: 18 Mediterranean Blvd S
Legal Description. St Lucie Gardens 26 36 40 That Part of ELKS 1 and 2 Lyg Ely of US#1 As Shown In or 2389-720
Being Lot 18 Mediterranean S (0.07 AC-3049 SF)(Or 3754-866)
Property Tax ID#: 3426-500-1090-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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Installing eight accordion shutters on the back lanai of the home.
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Additional work to fJ
r orme un er t is permit—c ec a app y:HVAC Gas Tank ❑Gas Piping M Shutters Windows/Doors
Electric 0 Plumbing Sprinklers MGenerator' Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 3200.00 Utilities:Sewer Septic Building Height:
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Name Helen Reily Name: Jeff Jackman
Address: 18 Mediterranean Blvd S Company: Master Craft Aluminum Products
City: Port St Lucie State:_ Address: 1634 SE Niemeyer Cir
Zip Code: 34952 Fax: City: Port St Lucie State:FI
Phone No.310-617-2223 Zip Code: 34952 Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page(if different E-Mail: mastercraftaluminum@gmail.com
from the owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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NO 9M
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Helen Reily Name:Jeff Jackman
Address:18 Mediterranean Blvd S Address: 18 Mediterranean Blvd S
City: Port St Lucie State: City: Port St Lucie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:1634 SE Niemeyer Cir 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
improvements to your property. A Notice of Commencement must be recorded 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.
Signa a ner essee/Contractor as Agent for Owner Si ure C ctor icense Holder
ST F FLORIDA S OF FLORIDA
COUNTY OF S rf,�ice. COUNTY OF Sri tw.1-Ir
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ay of UbW y- ,202) by this 1S6 day of 6C 41,1214 20_ by
Name of person making statement Name of person making statement
Personally Known l/ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary Pub7WExpires
eryl D.Moore (Signature of Notary Public-State of Florida )
TARY PUBLIC Sheryl D.Moore
Commission No. ATE OF FLORIDA Commission o PUBLIC
(Seal)
mm#GG945237 WPExpires
STATE OF FLORIDA
1115/2024 Comm#GG945237
1/15/2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17