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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 20Q un Permit Number:
RECEW-H FEB 09 2017
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 X
PERMIT APPLICATION FOR: Shutter
PROPOSED,IMPROVEMENT LOCATION:
Address. 2313 Jo Haywood Dr., Fort Pierce, FL. 34946
Legal Description: CITRUS HEIGHTS S/D LOT 16 (OR 1145-1342)
Property Tax ID#: 1432-700-0019-000-5 Lot No.16
Site Plan Name: Block No.
Project Name: Hurricane shutters (accordion type)
Setbacks FrontX Back: X Right Side: X Left Side: X
DETAILED DESCRIPTION OF WORK: `, =
10 accordion shutters
CONSTRUCTION INFORMATION:
l Additional work to bfl
orme un er t is permit—c ec a9Shutters
appy:
1]HVAC Gas Tank []Gas Piping Q Windows/Doors
Electric El Plumbing 05prinklers El Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 2,458.00 Utilities:cnSewer QSeptic Building Height: 15 FEET
OWNER/LESSEE CONTRACTOR:
Name Debra Wheeler Allen Name: Edwing O. Sosa
Address:2313 Jo Haywood Dr Company: Edwing's Unlimited Shutter Services, LLC.
City: Fort Pierce State-.FL. Address: 460 NW Concourse Place#16
Zip Code: 34946 Fax: City: Port St. Lucie State:FL.
Phone No.(772)240-9899 Zip Code: 34986 Fax: (772)905-9431
E-Mail: Phone No. (772)370-0766
Fill in fee simple Title Holder on next page( if different E-Mail: ed@edsunlimitedservices.com
from the Owner listed above) State or County License: 28457
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPP[ENIENTAC'CONSTRtlt� tON LIEN LAW IIVFORIVtATIOIV
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:
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
improvements to your property. A Notice of Commencement must be recorded 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.
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S a u e ner ssee/Contractor as Agent for Owner Signature of/Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF S �k rA COUNTY OF_ U W
The forgoing instrume t was acknowledged before me The forgoing instr ent was acknowledged before me
this 3 day of ���r ctu 20 Eby this day of
20 by
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(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
y � � i u ed Id9rPMN ,§RSA Personally Known Y OR Pro ced)dipntification
Persona!! Known .`; '
Type of Identification 9 c 1Q?rXvlN1lit,,kt on a Type of Identification Produced4"clo
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Commission No. F)"5 X op;°�� My Ca m. xpires May 29,2020
BondeAR h National Notary Assn.
Commission No.jF�
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Notary Public State of Florida
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Revised 07/15/2014 I %9,FO�Y`P� My Comm.Expires Sep 25,2019
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