HomeMy WebLinkAboutBuilding Permit Application I
iAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: � Permit Number:
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Planning and Development Services er �rUG�e CO
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Building and Code Regulation Division Commercial x Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 CBDG Funding
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PERMIT APPLICATION FOR: Hurricane Shutters
=R,ROPCISED,fIVIPROVEIVI;ENT LOCAT.ION:�:
address_ 9900 S Ocean Dr. #709, Jensen Beach, FL. 34957
Property Tax ID#: 4502-503-0073-000-9 Lot No.
Site Plan Name: Block No.
Project Name: William &Teresa Williams
1,,,""D'ETAILED,:D,ESCRIPTION,,OF,WORK:
1 accordion shutter(balcony area)
2 accordions (windows)
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 X Shutters —Windows/Doors —Pond
Electric Plumbing —Sprinklers Generator Roof Pitch
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Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 4,900.00 Utilities: _Sewer —Septic Building Height: 128 ft
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01NN'ER/LESSEE: CONTRACTOR
Name William &Teresa Williams Name: Juan F Sosa
Address: 9900 S Ocean Dr, #709 Company:Edwing's Unlimited Shutter Services LLC
city: Jensen Beach State: FL. Address: PO BOX 881085
Zip Code: 34957 Fax: City: Port St. Lucie state: FL.
Phone No. (850) 217-5063 E- Zip Code: 34988-1085 Fax: (772) 905-9431
Mail: Phone No (772) 340-0566
Fill in fee simple Title Holder on next page (if different E-Mail contact@edshutters.com
from the Owner listed above) State or County License 32279
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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-SU, -PLEMENTAL- CONSTRUCTION LIEN LAW INFORMATION
DESIGNER/ENGINEER: 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 conflicts with any applicable HomeownersAssociafion rules, bylaws o�and covenants that may resfrict or prohibit such—
I structure.Please consult with your Homeowners 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 of Owne'i/Lessee/C ntractor as Agent for Owner
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STATE OF FLORIDA ��11 �
COUNTY OF 3T, 1,U
Sworn to(or affir d)a d subscribed before me of Physical Presence or Online Notarization
th�is�A day of 201�f by
Name of person making statement.
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Personally Kn n_ OR Produced Identification
I Type of Id tifi on Prod ced_
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(Signature of Notary Public-State of Florida)
Commission No. 2 "f(Seal) �00 Notary Public State of Florida
Tiffany Lee Ferguson
EExxpiires 10 onoia otse7t
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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