HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ''\\
DowDate: May 5, 2021 Permit Number: ) I V ('9
C. L,ul C[L� .
RECEIVED
Building Permit Application
Planning and Development Services MAY 0 5 1011
Building and Code Regulation Division Commercial Residential x ,.rm; �Partrnent
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: HURRICANE SHUTTERS
Address: 5105 INDIAN BEND LANE FT. PIERCE, FL 34951
Property Tax ID#. 1312-800-0020-000-3 Lot No.189
Site Plan Name: REIGEL Block No.
Project Name: REIGEL
INSTALL FIVE (5) BAHAMA HURRICANE SHUTTERS
New Electrical Meter Second Electrical Meter
lip
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: $ 4,481.69 Utilities: —Sewer —Septic Building Height:
NameDANIEL REIGEL Name: MIRIAM VAN VASSEL
Address:5105 INDIAN BEND LANE Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State:L Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax: City: FT. PIERCE State:FL
Phone No.772 882 4061 Zip Code: 34951 Fax: 772-794-1590
E-Mail: Phone N0772-794-1581
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.
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.
Signatu of Ownery Lessee/Contractor as Agent for Owner Signature f Contractor/License Holder
STATE OF FLORIDA C f STATE OF FLORIDA
COUNTY OF �1 L
COUNTY OF � li -� 1
Swor to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Ph ical Presence or Online Notarization physical Presence or Online Notarization
this day of 2021 by this day of t`1 2024 by
a &_j 01 e
Nailine of person making statement. Name of person making statement.
Personally Known ✓FOR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Vivian� Sue Blume . `tU' ' v• ' an Sue Blume
(Signature of Nota Jq otklgf (Signature of Not#F.P -59 GG297M6
I�.April 29,2023 ;' ., sa EXPIRES:Mir 29, 2023
Commission No. BondoArY Aaron Notary Commission No. 'v�a` ���
Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.