HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date:
Permit Number:
1�lr
Building Permit Application
Planning and Development Services
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: HURRICANE SHUTTERS
-PROPOSED IMPROVEMENT LOCATION:
Address: 120 QUEEN BESS CT FT. PIERCE, FL 34949
Property Tax ID#: 1414-701-0148-000-5 Lot No.B
Site Plan Name: GOVERNALE Block No. 16
Project Name: GOVERNALE
DETAILED DESCRIPTION OF WORK:
INSTALL ONE(1) BAHAMA HURRICANE SHUTTER
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: Sq. Ft. of First Floor:
Cost of Construction:$ 2,002.97 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name LORRAINE GOVERNALE Name: MIRIAM VAN VASSEL
Address:120 QUEEN BESS CT Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State:ja, Address:3100 N. KINGS HIGHWAY
Zip Code: 34949 Fax: City: FT. PIERCE State:FL
Phone No.321 228 6236 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 lender or an attorney before commencing work or recording our Notice of Commencement.
Signature t
f Owner/Lessee/Contractor as Agent for Owner Signature Contractor/License Holder
STATE OF FLORIDA / / STATE OF FLORIDA > ,
COUNTY OF k�T , �/I,L/C 1 COUNTY OF
Swor (or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization -- rhysical Presence or Online Notarization
this _t�_day of Aor',_T__ 2020 by this��pday of �2020 by p
► " Ii n Q Ala SJe� I
Name of person making statement. Name of person making statement.
Personally Known 41 OR Produced Identification Personally Known —__,OR Produced Identification
Type of Identification Type of Identification
Produced Produced
�L�_ - a ' .,, avian Sue Blume 2 i— 'All, 11�� Viv' n Sue Blume
(Signature of Notary = 1i a Bf ON#GG297846 (Signature of Nota% a G297846
EXP CRE :April 29, 2023 ',; , . r EXPIRES:Apr 129,2023
Commission No. %T�'"' ``� BOnQ1ru Aaron Notary Commission No. ���ii ��`� Bonded T $ ron Notary
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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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