HomeMy WebLinkAboutOwen Chastain Building PermitAll 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 XXX
PERM ITTYPE:SHUTTER
Address:
C-`C
Property Tax ID #: Lot No.�
Site Plan Name: Block No.
Project Name:
INSTALLATION OF (`� HURRICANE ACCORDION SHUTTERS
C®NSTRCJCTI®N IAF®RMAT1L3Ne
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping -AShutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ \®i \1�
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
QWNER LESSEE:
C�NI�RA`CT�R. —
Nameo\Nk� mQS"1 f
Name:SAMUEL ZAZA
Company:JUST SHUTTER IT
Address: 10-1yI( reV k4fYO)O C;�_
City: ST LUCIE �— State: lr
Zip COde:-4,-\Q(�(a Fax:
Phone No.
Address:515 NW ENTERPRISE DR
City: PORT ST LUCIE State: FL
Zip Code: 34986 Fax: �"`---
Phone No772-201-9919
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailJUSTSHUTTERIT@GMAIL.COM
State or County License24293
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: xxx
Not Applicable MORTGAGE COMPANY: 10 Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: J Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a to do the work installation
permit and 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 IMPR VEMENTS TO YOUR PROPERTY. A NOTICE OF COM CEMENT MUST BE RECORDED AND
POSTED
ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU I ND TO OBTAIN FINANCING, CONSULT
WITH YOUR L ER OR AN ATTORNEY 139117-01119,112EC DING YOUR NOACE OF COMMENCEMENT."
Sign re of Own essee/Contra or s Agent for Owner
Signature of Contractor/Lice s older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFSTLUCIE
COUNTY OFSTLUCIE
The forgoing instrument was acknowledged before me
this \ day of QEC20ZO by
The forgoing instuement was acknowledged before me
1 1� �P
this day of (� , 20.W by
SAMUELZAZA
SAMUELZAZA
Name of person making statement.
Name of person making statement.
xx OR Produced Identification
Personal nown x OR Produced Identification
Type of dentification
C�l —
N
Produ ed
(Signature of Notary Public- State of Florida)
us ALYSSA A.T. BOWSER
(Sign re o otary Public- State of Vdo�r��ia )
�,� ALYSSA A.T. BOWSER
... c
Commission No. GG 295930 C *�, ,C r,�mmission # GG 295930
•f;. �eat7
Expires January 28, 2023
�, ,,,
mmission # GG 29593
Commission No. GG295930 Q
�tpires January 28, 202
9�F
oe
9TF OF F,OQ Bonded Thru Budget Notary Services
;
OF FLOP\ Bonded Thru Budget Notary Servic
a
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DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19