HomeMy WebLinkAboutPERMIT APPLICATION 5061 HWY A1A #206 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
Address: 5061 N HWY Al#206
Property Tax ID#: 1414-601-0010-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL 6 ELECTRIC ROLL SHUTTERS AND 1 MANUAL ROLL SHUTTER
New Electrical Meter Second Electrical Meter— (Affidavit required)
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: $ 25,638.00 Utilities: Sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR: I
Name Norma E Green.(_Tl�_c/o John K McClure Name: Thomas L Pease
Address: 211 S Ridgewood Dr Company: Florida Shutters Inc
City: Sebring State: FL Address: 1055 Commerce Ave
Zip Code: 33870 Fax: City: Vero Beach State:FL
Phone No. 863-402-1ggq Zip Code: 32960 Fax: 772-567-3674
E-Mail:john@JKmpa.com Phone No 772-569-2200
Fill in fee simple Title Holder on next page(if different E-Mail permitting(a�floridashuttersinc.com
from the Owner listed above) State or County License CBC 015451
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 UE1+1AW 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:
i 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 i!,suance 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 ules,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
wit Wender or an attorney re commencing work or recording your Notice of Commencement.
Signatur of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORWA _
COUNTY OF
Sworri.to(or affir d)and su scribed before me of �fiysical Presence or Online Notarization
this day of 20.�l by
i
Name of person making statement.
i
Personally Known OR Produced Identification
T pe of Identification Produced
(Signature of Notary Public-State of Florida )
E�q
............•. DEBORAH EMERICK
Commission No. (Seal) Notary Public-State of Florida
031 Commission k GG 952084
My Comrr.Expires Mar 20,2024onded t=ro�gh National Notary Assn.
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