HomeMy WebLinkAboutOwens 6030 - 3 Permit AppALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/14/21 Address Correction
Permit Number: 2105-0111
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 x
PERMIT APPLICATION FOR: Shutter
Address: 6030 Indrio Road Unit 3 (note: this is to correct address which was wrong on initial application)
Legal Description: Indian Pines Village Bldg. O Unit 3 and Pro-rata share in common elements (OR 3522-1902)
Property Tax ID #: 1313-501-0105-000/8
Site Plan Name: Indian Pines Village
Project Name: _
Setbacks Front
iamonai wo
❑HVAC
❑ Electric
Back: Right Side:
Installing two accordion shutters
e ertormea unaer tnis permit — ci
Gas Tank ❑Gas Piping
0 Plumbing Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 1,600.00
Left Side:
:11>fi1r.i1l
IVI Shutters
❑ Generator
S�Ftj of First Floor: _
UtiIities:I _ISewer Septic
Name Jessee T & Alinda C. Owens
Address: 5357 Oakland Lake Circle
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone N o. 336-345-8914
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Lot No.
Block No.
Windows/Doors
Roof Roof pitch
Building Height:
Name: Jeff Jackman
Company: Master Craft Aluminum Products
Address: 1634 SE Niemeyer Circle
City: Port St. Lucie State: FL
Zip Code: 34952 Fax: 772-335-0860
Phone No. 772-335-1177
E-Mail: mastercraftaluminum@gmail.com
State or County License: SCC131150586
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
_ Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
Sig toe o wn r/ Lessee Contractor as Agent for Owner
Si at r f ntr ctor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S*-WC C__
COUNTY OF S}•L•uLiL
The forVing instrument was acknowledged before me
instrument was acknowledged before me
The for Tod
this day of Junc, 20a by
this a►S day of �Sunt, 20 al by
T2�F .SAcic01^r
Je��- 7wckwiw,.,
Name of person making statement
Name of person making statement
Personally Known c./ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
�pR A Sheryl D. Moore
Commission No. NOTARY PUqt_Ka-I)
Commission No. tRRrq Sheryl D. Moore (Seal)
o3`TATE OF FLORIDA
NOTARY PUBLIC
•� rComir # GG945237
-STATE OF FLORIDA
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REVIEWS
FRONT
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SUPERVISOR
PLANS
VEGE AI9ION Ex
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MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17