HomeMy WebLinkAboutApplication for Storm Shutter Permit- Permit N` � r:
St. Lucie County 1 i/
Building & Zoning Department
• 2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-1553
APPLICATION FOR STORM SHUTTER PERMIT
L� SEE REVERSE SIDE FOR INSTRUCTIONS DATE: I o
1. LOCATION/SITE ADDRESS: 0 qq5 4—EEc" /I � ej
2. PARCEL ID NUMBER: _ _ 5 / 3 / 3 O W5- ®W - 2'
SECT I I TWP
as=ice
3. DESCRIPTION OF PROJECT OR WORK ACTIVITY:
ri M.MV i •y.
4. TYPE OF STRUCTURE: SIR X ADDITION OTHER
5. OWNER INFORMATION 6. CONTRACTOR INFORMATION
Name: � G .Qc)ot , FL Reg/Cert #: (��C- /5 Z7 gj
Address: �i�ki�I o c ��l� , County Cert #:
/c
City: T s��� / ,Q i Cie State: Business Name: � i oh�yg� J�G
Zip: Phone: 7 /yo? ,5—;=z• -7 ?may
Type of Surface attachment: Wood Frame Concrete Masonry Other
Product
Pe
Maximum Opening Pressure per
A.S.C.E.-7
Product Compliance
Report #
Methgd of Attachment
As per Product Approval or Engineers
Anal sis
120 mph
130 mph
140 mph
140 Exp. C
FL
N.O.A.
Other
Anchor Type
Anchor Spacing
Removable Panels
%
) u Z,
L
Accordion
-'
oll U
Colonials
ther
ALL PRODUCTS SHALL BE LABELED FOR DETERMINING IMPACT RESISTANCE FROM WIND BORNE DEBRIS.
**SEE FINAL INSPECTION PROCEDURE FOR EXISTING RESIDENTIAL STRUCTURES ONBACK
7. VALUE OF CONSTRUCTION: $ r).-- W J a, CI 0 FEES DUE:
RECEIPT:
OWNER'S AFF'IDAvrr: I certify that all of the information contained in this application is correct and that all work will be done in
compliance with all applicable laws regulating construction and zoning.
RINTP QU /O S N . IE ��^^��� SIGNATURE OF QUAi.iFiFR/OWNER
STATE OF
A, COUNTY
ACKNOWLEDGED BEFOREMETHISDAY OF20� BY, dC-1�X. �1n Q�1TA ERSONALLY O TO ME
OR WHO HAS PRODUCED an AS IDE CATION. �\��
TITLE:
OR PRIAT NAME OF NOT Y
;ION NUMBER
NOTICE TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
AUDREY B. HUMPHREY
'r MY COMMISSION # DD 633047
EXPIRES; March 6, 2011
fQ.Q Bonded?hru Notary Public Underwriters