HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_V y b�z bz k
Permit Number:
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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 XXX
PER 1TTTYPE:SHUTTER
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Address:_� 2q
Property Tax ID#: U j QZG 000 — U Lot No.
Site Plan Name: I -eP -\'� Block No.
Project Name: e-
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INSTALLATION OF HURRICANE ACCORDION SHUTTERS
CTION INFORMATON: --
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping Shutters —Windows/Doors
—Electric _Plumbing —Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ i 3�U Utilities: —Sewer —Septic Building Height:
OVUPVER/LESSEE;:
C� TFACT R
Name Name:SAMUEL ZAZA
Address: )�?q Company:JUST SHUTTER IT
City: ST LUCIE State: l— Address:515 NW ENTERPRISE DR
Zip Code:_3 L`1 Su Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34986 Fax:
E-Mail: Phone No772-201-9919
Fill in fee simple Title Holder on next page( if different E-MailJUSTSHUTTERIT@GMAIL.COM
from the Owner listed above) State or County License24293
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: xxx Not Applicable MORTGAGE COMPANY: 10 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 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 NTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR L ER OR AN ATTORNEY BEFORE RECORDING YOUR OTICE OF COMMENCEMENT."
n re of Ow r/Lessee/Coutr or as Agent for Owner Sinu e of Contractor/ is se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFSTLUCIE COUNTY OFSTLUCIE
The forgoing instrument.was acknowledged before me The forgoing instrument was acknowledged before me
this"° �� day of QoCk 20,0S� by this 1 day of aV 20!U by
SAMUEL ZAZA SAMUEL ZAZA
Name of person making statement. Name of person making statement.
Pers ally Known OR Produced Identification Personally Known xxx OR Produced Identification
Ty e of Identificatio Type of Identification
P od ce Produc
—L�?� J_J�
(Signature of Notary Public-State of Florida} (Signat a of Notary Public-State of Florida)
Shan puB< ALYSSA A.T.BOWSER E,P v pug, ALYS5A A.�.BOWS
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Commission No. GG295930 z c*(S��mission#GG295930 Commission No. GG295930 g ,, sa
I1commission#GG295 3
Expires January 28 2023 Ra Expires January 28,2 2
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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