HomeMy WebLinkAboutBuilding Permit ApplicationALL 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
Address: 3732 St Marks Dr, Ft Pierce, FI 34982
Legal Description: St James Park Blk 9 W 85 Ft Of ots 1 and 2 and W 85 ft of S 15 ft of lot 2 (OR 1626-1250)
Property Tax ID #: 2434-501-0117-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Installing twelve accordion shutters on the home.
Haaitionai worK to t)e nertormea unaer tnis permit — cnecK aii apply:
11HVAC L_I Gas Tank Gas Piping 12 Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers ❑ Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction: $ 4200.00 Utilities:Sewer Septic Building Height:
Name Esther Hippolyte
Address: 3732 St Marks Rd
City: Ft Pierce State:
Zip Code: 34982 Fax:
Phone No.772-621-0423
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Jeff Jackman
Company: Master Craft Aluminum Products
Address: 1634 SE Niemeyer Cir
City: Port St Lucie State. FI
Zip Code: 34952 Fax: 772-335-0860
Phone No. 772-335-1177
E-Mail: mastercraftaluminum@gmail.com
State or County License: SCC131150586
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name: Esther Hippolyte
Address: 3732 St Marks or, Ft Pierce, FI 34982
City: Ft Pierce
Zip: Phone
FEE SIMPLE TITLE HOLDER
Name:
Address: 1634 SE Niemeyer Cir
City:
Zip: Phone:
State
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: Jeff Jackman
Address: 3732 St Marks Rd
City: PortSt Lucie State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 your Notice of Commencement.
Signature 0 / ssee/ ontractor as Agent for Owner
Signa re of Cont ctor/License Holder
STAT�CLE�1 ID
COUNTY OF S. �uC� a
STAGE-@r ORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this `� ay of (�C-)-rJY,.tr 202o by
The forgoing instrument was acknowledged before me
this f�day of 29Z,0 by
�00+t7J-a
Name of perso making statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known r/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(JV ,
~lei/ 1'3i-L+�
(Signature of Notary Publl _ ate of� Moore
NOTARYaPUBLIC
Commission No. �STAT �7F)FLORIDA
(Signature of Not blicg �pWJWda )
NOTARY PUBLI�j
Commission N -+ OFFLORaal)
Ctxnrrr# GG945237
. .� Comm# GG945237
Nce i e
N Expires 1/15/2024
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
CONSTRUCTION LIEN LAW INFORMATION:
rSUPPLEMENTAL
DESIGNER/ENGINEER: _Not Applicable
Name:
Address:
MORTGAGE COMPANY:: Not Applicable
Name: —.
Address:
City: State: _
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
BONDING COMPANY: _NotApplicable
Name:
Address:
City:
Zip: Phone'
City:
Zip: _ Phone:.
OWNER[ CONTRACTOR AFFIDVIT: Application is herebymade 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.ofthe-granting of this requested permit, I,.do hereby;agre'e 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 follgviing.budding 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 T01 OWNER: Your failure to; Recorda 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
Ltacie County.and posted on he jobsite before the first ins ection. if yo tend to obtain financing, consult
with -:fender or i attorney -before commencing wo ..recording r Notice of Commencement.
F
nature Owner/ Lessee%Contractor as�Agent"for Owner Signatu C�qtractA..Icense Holder
STAT OF FLORID ATE OF
COUNTY OF COUNTY OF A ri
Sworn, to (or affirmed) and subscribed before me of S-wor o (or affirmed) an&subscribed before me of
tlysical Pr nce or Online Notarization P ysical Pres nce or:. . Online Notarization
this day of 2020 by this day of b &k9lfl iZ , 2020 by
Name of rson making -statement. Name of person making statement..
Personally. Known OR Produced Identificationy Personally Known ✓ OR Produced Identification I
Type..of Identification Type of Identification
Prod d Produced
(' t . e of Notary (5ig ure of No f Pu I - L L� / -� :i a
I rrYp�4'.. LASHAHNAINGR�,avtWkWING lo.
= i0 Notary P�bf'c Sfate of Fiof+da
:Commission No COMMIS&P.4 GG 2750GG { Commission ` n F Wilson �c�
EXPIRES: December 20,022 q�5 ; t y Comm�ss+oa GG 2T5°�71
so ��`' jr i In irn riNr^ + Expires 1110812022
I
REVIEWS FRONT- ZONING SUPERVISOR PLANS TATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW'.
DATE
RECEIVED
DATE.
COMPLETED {
ev. _
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