HomeMy WebLinkAboutBuilding permit app All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED o/►
Date: rv" Z Z((� Permit Number:
7N0,V
IVED
b) 2020
Building Permit Application ST. Lty, Permitting
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: tit CICA[Ve ,S 44 u `T /6✓Z_S
EDIMPROVEMENT LOCATION:
Address: 8204 COQUINA AVE. FT. PIERCE, FL 34951
Property Tax ID#: 1301-608-0111-000-4 Lot No.8
Site Plan Name: KEYSER Block No. 92
Project Name: KEYSER
INSTALL ALUMINUM HURRICANE SHUTTERS FOR TEN (10)OPENINGS
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping XShutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,774.11 Utilities: _Sewer —Septic Building Height:
;- ' CONTRACTOR:
NamedUDITH KEYSER Name:MIRIAM VAN TASSEL
Address:8204 COQUINA AVE. Company:DVT HURRICANE SHUTTERS, INC.
City: FT.PIERCE State:& Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax: City: FT. PIERCE State:FL
Phone No.772 979 5249 Zip Code: 34951 Fax: 772 794 1590
E-Mail:keyserjudith@gmail.com Phone No772 794 1581
Fill in fee simple Title Holder on next page(if different E-Mail dvthurricaneshuttersinc@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.
„1 FAk QNSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State:_ City: State:_
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
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 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 attorney before commencing work or recordo your Notice of Commencement.
Signatureof Owner/Lessee/Contractor as Agent for Owner Signa ure of Contractor/License Holder
STATE OF COUNTY FLORIDA ( I STATEOFFLORIDA
J 1 COUNTY OF
Swnto(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
_Physical Presence or Online Notarization Physical Presence or Online Notarization
this day of 2020 by this-2dayof AJovp i✓` 2020 by
idlgm
Name of person making statement. Name of person making statement.
Personally Known ✓ OR Produced Identification_ Personally Known / OR Produced Identification
Type of Identification Type of Identification
Produ
f� t.� Vvian Sue Blume ,- � � Mvian Sue Blume
/U C MISSNMIiGG1S7 M '-` SS =OG297846
(Signature of NotarytAebl Ip o I�I9,1�Ra[9;Apol29,2023 (Signature of Notary !1R ON 1 Apr1120,2023
n, r. BaId�IJ Aalpl NOWy BaIM11tl Thlu Aron Nobly
Commission No. ea Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.