HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 7 202I Permit Number:
o
v Building Permit Application
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
PERMIT APPLICATION FOR: Hurricane Shutters
PROPOSED IMPROVEMENT LOCATION:
Residential XXXXXXXX
Address: 6604 (gala Avenue Fort PiprreFI .349,51
Property Tax ID #: 1301-612-0353-000-5 Lot No.11
Site Plan Name: Block No. 133
Project Name:
DETAILED DESCRIPTION OF WORK:
Installation of (2) openings with Accordion Shutters FL#389
Installation of (1) opening with Aluminum Panels FL#11964
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
(Affidavit required)
_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: S 2582.92 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ingrid A Jackson
Name: _Donald J. Young
Address: 6604 Ocala Avenue
Company: Extreme Shutter Systems
Address:p_O_ Box 1216
City: Fort PiPrr.P State: fj_
Zip Code: 34951 Fax:
City: Fellsmere State: FL
Phone No. 207-631-9255
Zip Code: 32948 Fax: 772-571-5576
E-mail: i0ackson9255@,Qmail.com
Phone No 772-571-5574
Fill in fee simple Title Holder on next page (if different
E-Mail aaron.extreme@outlook.com
from the Owner listed above)
State or County License32234
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: X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
BONDING COMPANY: X 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 arLattorney before commencing work or recording our Notice of Commencement.
ov /)/'�
esse /Con ractor as Agent for Owner
Signature of O ZDA
STATE OF FLO
COUNTY OF
Sworn to (or affirmed) a d subscribed before me of Physical Presence or Online Notarization
this � day of J �� �y 20� by
Name of person making statement.
Personally Known V OR Produced Identification
roduce
Type of Id77,
(Signature of Notary Public- State of Florida )
"A*y4&.•., AARON JOHN CHANDLER
Commission No. ��� t' Ila2 (Seal) +P; Notary public • State or Florida
s " Commission 0 HH 1162I3
1 a M1 My Comm. Expires Apr 11, 2025
., Bonded through National Notary Assn.
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