HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 JA�. _`P 2021 Permit Number: all (3-0 l
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division, COPYIIYIeI Cial 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: 4200 N HIGHWAY A1A UNIT 915 FT. PIERCE, FL 34949
Property Tax ID#: 1423-501-0167-000-8 Lot No.
Site Plan Name: THEORDORE HERMANN Block No.
Project Name: THEORDORE HERMANN
DETAILED DESCRIPTION OF WORK:
INSTALL ONE (1)ACCORDION HURRICANE SHUTTER
New Electrical Meter Second Electrical Meter
�,CONSTRUCTIONINFORMATICIN:
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:$ 3,134.04 Utilities: —Sewer —Septic Building Height:
'bWN.ER/LESSEE: CONTRACTOR: "
Name THEORDORE HERMANN Name: MIRIAM VAN VASSEL
Address: 4200 N HIGHWAY A1A UNIT 915 Company:DVT HURRICANE SHUTTERS, INC.
City: FT. PIERCE State: . Address.3100 N. KINGS HIGHWAY
Zip Code: 34949 Fax: City: FT. PIERCE State:FL
Phone No.860 929 2890 Zip Code: 34951 I Fax: 772-794-1590
E-Maid: Phone N0772-794-1581 j
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: !
i
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: i _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. j
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 Amendment's.
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 ender or an attorney before commencing work or recording our Notice of Commencement.
Signature f Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA // STATE OF�FLORIDA
COUNTY OF 12• 1' e / COUNTY OF /ZZ 0'k-
Sworq,to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
!/P�sical Presence or Online Notarization ;/Physical Presence or Online Notarization
this S day of O c_�b e 202$ by this day of (1) C 202A by
If _�61_e Z
Name of person making statement. Name of person making statement.
Personally Known ---'OR Produced Identification Personally Known ___ OR Plroduced Identification
Type of Identification Type of Identification
Produc d Produc
-d
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida:)
Commission No. .�����¢ r''% �S a BUG' BIUI3t+ : Commission No. I .,
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_* CONiMI SfON GG297 r �5 COMMISSION#GG297846
Cp�YDIREe:April� ��i 2 -�� _ April023
REVIEWS FRON�'''��+�i�in"�ONIIQ�d� W �/fSO�tI. PLANS VEGETATIO',".,i • U96hded lil�A�Wbtll i
COUNTER REVIEW REVIEW REVIEW REVIEW "' "" EVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev.5/6/20