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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:SHUTTERS
PROPOSED IMPROVEMENT LOCATION: PATIO
Address: 1815 BUTTONBUSH CIR
Property Tax ID #: 4426-802-0016-000-7 Lot No.
Site Plan Name: Block No.
Project Name: GREENE
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (2) ELECTRIC ROLL -UP SHUTTERS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit – check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 11374.00
Generator
Sq. Ft. of First Floor:
Windows/Doors Pond
Roof Pitch
Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name _Jdhna-"un Gice–Cn2.
Name:JOHN FISCHER
Address: k`RkS ?Solt*ah C:kf
Company:ARMOR SCREEN CORPORATION
City: 1�G1m G�.I State: FL
Zip Code: guy o1 QO Fax:
Phone No.
Address:2744 HILLSBORO ROAD
City: WEST PALM BEACH State: FL
Zip Code: 33405 Fax: 561.841.8892
Phone No 561.841.8890
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail PERMffTWG@ARfbQRSC EENN .CCrM
State or County License CGC1522990[
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:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
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 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 recording our Notice of Commencement.
Rev. 5/6/20
o Owner/ Lessee Contra or as A nt for Owner
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Signatur Contract r/License Holder
STATE OF FLORIDA'
STATE OF FLORIDA
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Sworn to (or affirmed) and subscribed before m
Sworp to (or affirmed) and subscribed before me of
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this day of C'C �V_f-A� , 2020 by
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Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20