HomeMy WebLinkAboutAPPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
-�v fl—LI]CIEL 'R
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34992
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Debra Flax
PROPOSED IMPROVEMENT LOCATION:
Address: 9066 Pumpkin Ridge Rd Port St Lucie, FL 34986
Property Tax ID g: 3322-505-0159-000-7 Lot No. 150
Site Plan Name: Debra Flax Block No.
Project Name: Debra Flax
DETAILED DESCRIPTION OF WORK:
Installation of hurricane protection products on ( 6 ) openings
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _Gas Tank _Gas Piping XShutters X Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ $18,756.00 Utilities: _Sewer _septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Debra Flax
Name: Noreen Rayner
Address: 9066 Pumpkin Ridge Rd
Company: Storm Smart of Southeast FL
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No. (772) 528-5548
Address: 4047 Okeechobee Blvd Suite 106
City: West Palm Beach State: FL
Zip Code: 33409 Fax: (844) 330-8277
Phone No (561) 229-0048
E-Mail: df000dle(gcorrcastnet
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail permitting@stormsmartse.com
State or County License CRC1332755
n value or construction is Z!W or more, a KLEURDFD Notice of commencement is required.
H value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name:
XNot Applicable
MORTGAGE COMPANY:
Name:
X NotApplicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State: _
FEE SIMPLE TITLE HOLDER:
Name:
X Not Applicable
BONDING COMPANY:
Name:
XNot Applicable
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:
improvements to yI
Lucie County and pt
of Commencement may result in paying twice for
mencement must be recorded in the public records of St.
first inspection. If you intend to obtain financing, consult
bC�(IILL F: V- `7"/ Uirr �n�.ur x-
SignatureofOwner/Lessee/Contractor as Agent for Owner Signa umofC a or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St. Lucie COUNTY OF St. Lucie
Sworn to (or affirmed( and subscribed before me of
X Physical Presence or Online Notarization
this Zf_day of 3UL-Y 2020 by
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Commission No. llo®43t. (Seal)
Sworn to (or affirmed) and subscribed before me of
k Physical Presence or Online Notarization
this 24 day of Si i Kn iPty' . 2020 by
Noreen Rayner
Name of person making statement.
Personally Known A OR Produced Identification X
Type of Identification
Produced Dl ,
(Signature of Nary Public -State of Florida I
Commission No. I t„to 3t a (Seal)
REVIEWS COUNTER I REVIEW SUPERVISOR
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