HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Ja+ , 9 , 2021 Permit Number: QVT1
FIEC.EM
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P L 0 1� L L Building Permit Application
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Planning and Development Services e i ng
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: 14366 AZUCENA COURT FT. PIERCE, FL 34951
Property Tax ID#: 1306-501-0559-000-3 Lot No.4
Site Plan Name: BRENTON Block No. 34
Project Name: BRENTON
DETAILED DESCRIPTION OF WORK:
INSTALL TWO (2)ACCORDION HURRICANE SHUTTERS
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 X Shutters _Windows/Doors _Pond
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1,500.74 Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name LINDA BRENTON Name: MIRIAM VAN VASSEL
Address:14366 AZUCENA CT. Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State:_E Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax: City: FT. PIERCE State:FL
Phone No.480 335 7001 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.
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
withJqnder or an attprney before commencing work or recording our Notice of Commencement.
I,
Signature Pf Owner/Lessee/Contractor as Agent for Owner Signature of Contrac or icense Holder
STATE OF FLORIDA n/ STATE OF FLORIDA
COUNTY OF COUNTY OF
Sworn to(or affirmed)and subscribed before me of Swo n to(or affirmed)and subscribed before me of
V Physical Presence or Online Notarization P ysical Preserve or Online Notarization
this�day of k-1k / 202* by this day of JCS/ 202,1 by
freeNflt 1,oA fa�sP / gy'l /alit Lk 1�5)x/
Name of person making statement. Name of person making statement.
Personally Known •,i OR Produced Identification Personally Known y_OR Produced Identification
Type of Identification Type of Identification
Produced Produce
ue Blume
(Signature/of Notary oft I SCION#GG297846 (Signature of Notary OCOMIiM ON 0 GG297846
Commission No. " EXPIMI)April 29, 2023 Commission No. EXPIR � b
� it 29, 2023
Bonded Thru Aaron Notary ������������ Bonded ru Aaron Notary
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.