HomeMy WebLinkAboutPermit Application_00000ALL 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
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 6040 Indrio Rd. # 08
Legal Description: INDIAN PINES VILLAGE- BLDG T UNIT 8 AND PRO -RATA SHARE IN COMMON ELEMENTS
Property Tax ID #: 1313-501-0150-000-8
Site Plan Name:
Project Name: Weaver, Jason
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
INSTALLATION OF HURRICANE SHUTTERS
Lot No._
Block No.
CONSTRUCTION INFORMATION:
Additionaiw&rktobenertormedund-e—rt-F Is permit -check all that appy:
HVAC Gas Tank 7Gas Piping Shutters Q Windows/Doors
11 Electric Plumbing Sprinklers Generator El Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,708.00 Utilities: 0 Sewer []Septic
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Weaver, Jason
Name: Robert McNally
Address: 6040 Indrio Rd. #08
Company: Palm Coast Shutters & Aluminum Products. Inc.
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No.
Address: 675 4th St.
City: Vero Beach State: FL
Zip Code: 32962 Fax: 772-299-1958
Phone No. 772-299-1955
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: Giovanna(a)pal mcoastshutters. com
State or County License: CBC1262166
If value of construction is 5z5oo or more, a KLLUKUtU NOLICe O7 t.OmrnenAemenL 15 1 cyan cu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: N/A
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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
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
-ornmencing WOFK OF fCCUf U If 19 YUU1 IVUIILC UI I I iiiciicciiicii�.
Signatur f Owner/ Lessee/Contractor as Agent for Owner Signature of Contra
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this10 day of June , 20ZO by
son Weaver
Name of person making statement
Personally Known _,4 OR Produced Identification
Type of Identification
Produced
(Signature of N to P Ii - t
d' r Notary Pubt; State of Floc da
Commission No. vanna [ kil
My Commission GG 287096
Expires 01126/2023
REVIEWS I FRONTZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
STATE OF FLORIDA
COUNTY OF IND1hN
Ider
COUNTY
The forgoing instrum nt was acknowledged before me
this ,eOL day of 20 U by
ROBERT MC NALLY
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Fu—re Vf Notary Public- State of Florida )
CommisstorT 91 - - " - - - - -
,s�' o ary u s to W Flon
'f' Giovanna Drausal
.. My commission GG 267096
SUPERVISOR PLANSANGROVE
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