HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /l /\ _
Date: March3, 2021 Permit Number: �D U�J
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Planning and Development Services A
Building and Code Regulation Division Commercial Re In I I G
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 ��� �Oj!
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PERMIT APPLICATION FOR: HURRICANE SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 5102 INDIAN BENT LN FT. PIERCE, FL 34951
Property Tax ID#. 1312-800-0013-000-1 Lot No. 182
Site Plan Name: WILCENSKI Block No.
Project Name: WILCENSKI
DETAILED DESCRIPTION OF WORK:
INSTALL THREE (3)ACCORDION HURRICANE 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 X Shutters _Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 7,787.55 Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name MARK WILCENSKI Name: MIRIAM VAN VASSEL
Address:5102 INDIAN BENT LN Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State: Fl- Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax: City: FT. PIERCE State,FL
Phone No.772 464 7465 Zip Code: 34951 Fax: 772-794-1590
E-Mail: 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.
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SUPPLEMENTAL CONSTRUCTION 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 I er or an attorney fore commencing work or recordin&Xour Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of C ntractor/Lice se older
FLORIDASTATE OF �� / STATE OF FLORIDA
COUNTY OF /
l� � COUNTY OF l��t�Q,
Swor (or affirmed)and subscribed before me of Sworn o(or affirmed)and subscribed before me of
Physical tosence or Online Notarization Physical Presence or Online Notarization
this day of rl AY- 202P by this day of— 202f by
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7,4 C. e) ir t-N,
Name of person making statement. Name of person making statement.
Personal) Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identi ication Type of Identification
Produced Prod d
`11,t.. V ian Sue Blume ���.,,, Vivian Sue Blume
(Signature of Nota W408K Vs)f ignature of Notary PllkE t., F r
�S EXPIRES:April 29 2023 p,,�Ih S:April 29, 2023
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Commission No. �''�TFgF' ,.�` gon Aaron Notary Commission No. ���''�/I '•�N�````` **Wu Aaron Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
NOTICE OF COMMENCEMENT
Permit No. Property Tax ID No. 1312-800-0013-000-1
State of Florida,County of St.Lucie
The Undersigned hereby gives notice that improvement will be made to certain real property,and in accordance with
Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement.
Legal Description of property and address if available
HOLIDAY PINES S/D-PHASE II-A- LOT 182 (MAP 13/13N) (OR 3721-1362)
General description of improvements INSTALLATION OF HURRICANE SHUTTERS
Owner/lessee MARK WILCENSKI
Address 5102 INDIAN BEND LN FT.PIERCE,FL 34951
Interest in property: 100%
Fee Simple Title holder(if other than owner)
Address
Contractor DVT HURRICANE SHUTTERS, INC Phone# 772-794-1581
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Address 3100 N KINGS HWY, FORT PIERCE, FL 34951 Fax# 772-794-1590 —
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Surety Phone# Zoo&cr m
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Address Fax# o N 0 3
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Amount of Bond S 0 N z m
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Lender Phone# W N 0
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Address Fax# W� x
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Persons within the State of Florida designated by Owner upon whom notices or other documents may be served a `n
by Section 713.13(a)7.,Florida Statues: ° K m
Name Phone# i 0
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Address Fax# Z E
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In addition to himself,owner designates 0
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Phone# Fax#
to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b),Florida Statutes. Expiration date 4
commencement is one year from the date of recording unless a different date is specified. WARNING TO OVI
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDEREI
PAYMENTS UNDER CH.713.13,F.S.,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF
COMMENCMENT.
Owner/Lessee,or Owner's or Lessee's Authorized Officer/Director/Partner/Manager/Signature
Signatory's Title/Office
State of Florida,County of 5+• L,,,—A
Acknowledged before me this ;�-] ,day of 20'Z 1 ,by
who ispersonally known to me or who has produced as identification.
Signature of Notary Type or Print Name of Notary eal)
Won Sue Blume
Title: Notary Public Commission Number n COMMISSION*GG297846
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EXPIRES: April 29, 2023
�'�� ;g Bonded Thru Aaron Notary