HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: JuIY;4 2021 Permit Number: �? 0 % ^ 03
'R
-I D A
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECENgD
Building Permit Application
st, NON�
Residential
PERMIT APPLICATION FOR: HURRICANE SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 6765 PICANTE CIR FT. PIERCE, FL 34951
Property Tax I D #: 1306-500-0237-000-7
Site Plan Name: KEEHN
Project Name: KEEHN
DETAILED DESCRIPTION OF WORK:
INSTALhSEVEN (7) ACCORDION HURRICANE SHUTTERS
LEXAN PANELS FOR ONE (1) OPENING
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed- under this permit — check all that apply:
JUL 2 a 202,
Lot No.7
Block No. 53
_Mechanical _ Gas Tank —Gas Piping Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 3,625.73
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LEE KEEEHN \
Address: 6765 PICANTE CIR
City: FT. PIERCE State:,
Zip Code: 34951 Fax:
Phone No. 269 579 4455
Name: MIRIAM VAN VASSEL
Company:DVT HURRICANE SHUTTERS, INC.
Address:3100 N. KINGS HIGHWAY
City: FT. PIERCE State: FL
Zip Code: 34951 Fax: 772-794-1590
Phone N0772-794-1581
E-Mail dvthurricaneshuttersinc@hotmail.com
E-Mail:
Fill in fee simple Title Holder on next page ( if different
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
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 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 recordip"our Notice of Commencement.
'Ell
Signature Pf Owner/ Lessee/Contractor as Agent for Owner
Si ature of C ractor/License Holder
STATE OF FLORIDA , /
07�,
STATE OF FLORIDA / �
COUNTY OF /� ll(',� Q,
COUNTY OF C / & _,'Z
Sworn o (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
✓
ysical Presence r Online Notarization
this � day of 202� by
Physical Presence or Online Notarization
this - day of 2020 by
14 A l �� l
/�'� /'d x ��,s s %
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known FOR Produced Identification
Type of Identification
Type of Identification
Prod uc di
Pro=-C-41' Vivi n Sue Blume
(Si nature of Notary Pub ' - ate of rich
��}' 011,, '�%ivsarti Sue Blume
( gnature of Notary P1IKic- t44 F i GG297846
Commission No. =? f'= COMI I)ON#60297846
<� EXPIRES: April 29 2023
Commission No. 90ni Aaron Notary
-,' EXPIRES: April 29, 2023
*Zg
tionaeo I hi
u Aaron Notary
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