HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/11/2020 Permit Number:
Sqm
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Accordion Shutters
PROPOSED IMPROVFMFNT I nrATInN-
Address: 3800 Anacostia Place
Property Tax I D #: 2519-800-0012-000-2
Site Plan Name: Knowles Shutters
Project Name: Shutters
Anacostia
DETAILED DESCRIPTION OF WORK:
Installing 2 Accordion Shutters
Bertha HV Accordion Shutter 1850.3
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 - Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 5,228.00
OWNER/LESSEE:
Name Russell Knowles
Address: 3800 Anacostia Place
City: Fort Pierce, FL State:
Zip Code: 34949 Fax:
Phone No.772-201-0120
E-Mail:
Sq. Ft, of First Floor:
Residential X
1
Lot No. 7
Block No.
Windows/Doors Pond
Roof _ _ Pitch
Utilities: —Sewer —Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
CONTRACTOR:
Name: Michael O'Donnell
Company: O'Donnell Contracting LLC
Address: 1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone N0772-408-0200
E-Mail odonnellpermitting@gmail.com
State or County License CRC1331273
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 LAND IN
DESIGNER/ENGINEER: _ Not Applicable ,
Name:
Address:
City: ate:
Zip: Phone
FEE SIMPLE TITLE HOLD : Not Applicable
Name:
Address:
City:
s]
MORTGAGE COMPANY:
Name:
Address:
City: �—
Zip: -Phone:_
- "Not Applicable
State:
BOND COMPANY: Not Applicable
Address:
City:_
Zip: Phone: Zip: Phone:
O NER/ 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 Assoclation 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 len or an atto " ore commencing -work or recordingrV66rVej;fte of Commencement.
re of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Mn f4 ►
Swar (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
M C
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
P oduced
(signature o Natary u ic- State of Florida
y° Wynn Xhen
Commission No.: gglpm, #"V6562
REVIEWS FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
ure of Contractor/U&ms0-F{older
STATE OF FLORID
COUNTY OF.�1
Swo�a (or affirmed) and subscribed before me of
Y Physical Presence or Online Notarization
this _ day of 2020 by
Name of person ma:"=oduced
nt.
Personally Known Identification
Type of Identification
Produced
� Lkha=:
(Signature of No ry Publ' State of Flp ida }
� 1 y�*�.ynn A«en
Commission No. _ "' GQl'[ImIGG366562
>r res: SeM. 30 2023
SUPERVISOR I PLANS VEGETATION SEATURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW