HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date:W���020 Permit Number: �J I O - (01 n2,
RECEIVED
Ta o OCT 2 7 2020
Building
tj Q R • -
Permit Application Permittin
Department
ie County
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:HURRICANE SHUTTERS
PROPOSED'IMPROVEMENT LOCATION:.`
Address: 3075 GORDY RD. FT. PIERCE, FL 34945
Property Tax ID #: 2323-501-0075-000-2
Site Plan Name: FORGET
Project Name: FORGET
F I DETAILED DESCRIPTION OF WORK:
INSTALL FIVE (5) HURRICANE ACCORDION SHUTTERS AND
New1lectrical Meter
ALUMINUM PANELS FOR FIFTEEN (15) OPENINGS
Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping A Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 8,701.35
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LOUIS FORGET
Name: MIRIAN VAN TASSEL
Address: 3075 GORDY RD.
Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State: fZ
Address:3100 N. KINGS HIGHWAY
Zip Code: 34945 Fax:
City: FT. PIERCE State: FL
Phone No. 772 216 4765
Zip Code: 34951 Fax: 772 794 1590
Phone No 772 794 1581
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail DVTHURRICAN ES H UTTERS INC@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:
DESIGNS
Name:_
Address:
City:
Zip:
Phone
Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
City: 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 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 attornev before commencine work or recordine vour Notice of Commencement.
Signature 01 Owner/ Lessee/Contractor as Agent for Owner
Signature of ntractor/License Holder
STATE OF FLORIDA j 1�J
STATE OF FLORIDA '
COUNTY OF ST ` (i
-jI
COUNTY OF .54
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
�hysical Presence or Online Notarization
�ysical Presence,p r Online Notarization
this day of (7 �—2020 by
thisr��day of C�� , 2020 by
Vck
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Name of person making statement.
state�ment.
Name of person making statement.
n
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Vivi n Sue Blume
_ V,'��� 1vian ue Blume
(Signature of Notary }lic atff8f F
-� 0 S: April 29. 2023
���''n`i°F
(Signature of Not e - tt�te a Aril 29, 2023
E`i ���C
'��i'�..
Commission No. a�``�� BOnt0attinj Aaron Notary
Commission No. ���``�+ Bonded T ron Notary
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