HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETEDTOR APPLICATION TO BE ACCEPTED
Date: 3 �� a`, Permit Number:°Z�d3"�3�3
,— RECEIVED
Loa'Ul eI �p ry
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� � � �` Permittin
Building Permit Application St. Luci�oartment
Planning and Development Services
ty
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: e.
PROPOSED IMPROVEMENT LOCATION:
Address: 9051 SHORT CHIP CIR,PORT ST LUCIE,FL 34986
Property Tax ID#:3334-501-0168-000-8 Lot No.30
Site Plan Name: Block No.
Project Name:ALBRITTON,JANIS S
DETAILED DESCRIPTION OF WORK:
INSTALL(11)ACCORDIONS AND(5)IMPACT SH WINDOWS
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 Windows/Doors _Pond
_Electric —Plumbing _Sprinklers Generator _Roof Pitch
Total Sq. Ft of Construction: 0 Sq. Ft.of First Floor:
Cost of Construction: $ 12278.31 Utilities: _Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
NameALBRITTON,JANIS S Na me:Jeffrey Tollison
Address:9051 SHORT CHIP CIR Company:ALL AMERICAN SHUTTERS AND GLASS
City: PORT ST LUCIE State:FL Address:1638 Donna Road
Zip Code: 34986 Fax: City: West Palm Beach State:FL
Phone No.772-828-1402 Zip Code:33409 Fax:
E-Mail: Phone No 561-712-9882
Fill`in fee simple Title Holder on next page(if'different E-Mail permits@levinsonbuilt.com
from the Owner listed above) State or County License CGC 1512423
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. 1;4;
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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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Counrrttyy makes no repre entation that is granting a ermit will authorize the permit holder to build the subject structure
which is in conflict with any appi cable 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.
i, gna re of Own r/Agent/Leksee Signature of Co ra Licen Holder
STATE OF FLORIDA � //� STATE OF FLORIDA
COUNTY OF `'r9/rir ��itcGr COUNTY OF
The forgoing instrument was,acknowledged before me The fo oing instrument was acknowledged before me
this�day of W,-w t4 2p�1 by this day of - 7 f by
(Name of person acknowledging} (Name of person acknowledging)
I,U I V I y
Signature of Nota Public-talos
of Flo id ) (51 nature of Notary P blic-Sta o lorld }
Personally Known . OR Produced Identification y Personally Known 0R Produced Identification
Type of Identifiication Produced L Type of Identification Produced
Commission No. Sasha Gonzalez Commission No. _
Commission#HH 10592. �Pn'y �e� Sasha Gonzalez
Commission Expires O6.15 2024 2 Commission#HH 10592
Bone roug yn Bonded Through-Cynanotary
Revised 07/15/ T OFr- Florida-Notary Public Bonded
Florida-Notary Public
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS