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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: September 10,, 2021 Permit Number:
c L1!1�G RECEIVED
O
° Building Permit Application SEP 10 2021
Planning and Development Services St.Lucie County
Pgrmitf* g
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
HURRICANE SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 4605 EAGLE DR FT. PIERCE, FL 34951
Property Tax ID#: 1312-801-0038-000-5 Lot No. 235
Site Plan Name: THIM Block No.
Project Name: THIM
DETAILED DESCRIPTION OF WORK:
INSTALL THREE (3) HURRICANE ACCORDION SHUTTERS
New Electrical Meter Second Electrical Meter
I CONSTRUCTION INFORMATION:
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: $ 2,018.61 Utilities: —Sewer _Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
NameWILLLIAM THIM Name: MIRIAM VAN VASSEL
Address: 4605 EAGLE DR Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State:_EZ Address:3100 N. KINGS HIGHWAY
Zip Code: 34951 Fax: City: FT. PIERCE State:FL
Phone No. 772 466 8009 Zip Code: 34951 Fax: 772-794-1590
E-Mail: Phone No 772-794-1581
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.
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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
with lender or an attorney before commencing work or recording our Notice of Commencement.
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Signature o Owner/Lessee/Contractor as Agent for Owner Signatur of Contractor/License Holder
STATE OF FLORIDA , ; I STATE OF FLORIDA
COUNTY OF JZ /P 1 COUNTY OF '_
VSw rn to(or affirmed)and subscribed before me of Swor to(or affirmed)and subscribed before me of
Physical Presence o Online Notarization ✓ Physical Presence r Online Notarization
this day of ? P P 202p by this /J day of •?, 202� by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known --� OR Produced Identification
Type of Identification Type of Identification
Produced Produced--,
(Signature of Notary P te oVWIM l Sue Blume (Sig ature of Notary Pul� aLe�of P�ah Sue Blume
r,�}M N wz9�eas COMM GG297846
Commission No. Commission No. = °
... ;iM EXPI ES:Aprl 29, 2023' FXPIRFS' April 29, 2023..
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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