HomeMy WebLinkAboutBuilding Permit Application iAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1
Date: • 3 Permit Number: C / ��' ��
[Ln nCE �� RECEIVED lul MAR 0 3 1011
Building Permit Application PermittingDepartment
Planning and Development Services St.Lucie County
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: SHUTTERS
n"i ROVEM5,NTLOCATIQN:
2
Address: 5404 SUSON LN
Property Tax ID#: 1312-500-0051-000-8 Lot No. 50 -
Site Plan Name: Block No.
Project Name:
�DETAttI`LED M'cRIPTION'O.F
INSTALL 7 ACCORDION SHUTTES
New Electrical Meter Second Electrical Meter
O ruz..§v $
CONSTR>{t,CTIN,INF,ORMATION ;
Additional work to be performed under this permit—check all th apply:
_Mechanical Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.-of-First Floor:-
Cost of Construction:$ 5,374.00 Utilities: —Sewer —Septic Building Height:
i®1NNER%LESSEE`S a CONTRA"CTOR s
Name SCOTT CAMERON Name:THOMAS L PEASE
Address:5404 SUSON LN Company:FLORIDA SHUTTERS INC
City: FORT PIERCE State: Address:1055 COMMERCE AVE
Zip Code: 34951 Fax: City: VERO BEACH State:FL
Phone No.772-467-1038 Zip Code: 32960 Fax: 772-567-3674
E-Mail: Phone N0772-569-2200
Fill in fee simple Title Holder.on next page(if different E-Maildaniela@floridashuttersinc.com
from the Owner listed above) State or County License CBC 015453
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.
611 P 0:14` N AL C'NSTRUC,TION if N.LAW INFORMATION
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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 lender or an attorney before commencing work or recording our Notice of Commencement.
cc S'e-
Signature of Owner/Lessee/Contractor as Agent for Owner Signat re'bf Contractor/License Holder
STATE OF FLR;JPp QL �7 STATE OF FLORIDA
COUNTY OF r!nd4" COUNTY OF ��� �t Jkx—
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
✓Physical Pre nce or Online �� 77
,p on ��h�ical Presence or Online Notarization
this Soda of e -c rt. .�A4 �t�
r�1�OB®p9/e this 3 day of (%V.1_rZC3T 2020 by `
Name of person making staterr�_nt.:��Q,�� ^ �o Name of person making statement. o ry
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Personally Known 0 roduced r�°St cation i t= Personally Known ✓ OR Produced Identificatio
Type of Identification o o^0 Type of Identification
4799 h
Produced 9•°�ye°9ded kk%I (� o Produced
ram® A e• b/ic•Undg�;, a E E
STATE
(Sign ture of Notary Public-Sta Flor(6a ) ! (Signature of Notary Public-State of Florida)
Commission No. �v (Seal) Commission No. I 3 21 (Seal)
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