HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
D Permit Number:
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Building Pei mit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:SHUTTERS
PROPOSED IMPROVEMENT LOCATION:
orlrlr,,,- 5514 SUNSET BLVD
Property Tax ID #: 3402-609-0273-000-6
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
INSTALL TWO BAHAMA SHUTTERS
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. 115
Block No. 59
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 Sn Ft nf rnnctnIrtinn _ _ So. Ft. of First Floor:
Cost of Construction: $ 2,350.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameDUSTIN DAVIS
Name:THOMAS L PEASE
Address:5514 SUNSET BLVD
Company: FLORIDA SHUTTERS INC
City. FORT PIERCE State:
Zip Code: 34982 Fax:
Phone No. 772-519-3104
Address:1055 COMMERCE AVE
City: VERO BEACH State: FL
Zip Code: 32960 Fax: 567-3674
Phone No569-2200
E-Mail:ldyravn@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County LicenseCBC 015453
If value of construction is 25ou or more, a KtLUKUtU IYOTICe DI %.V[rlrnent,en]cnL n IC4W11 cu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
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 Horne 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 S::3mmencement may result in paying twice for
improvements to your property. A No ' f Commencement must be recorded in the public records of St.
Lucie Coun y and posted on th Slte befo the first inspection. If you intend to obtain financing, consult
with lende ran ne ore commencin work or r Notice of Commencement.
Signature of Owne Lessee Contractor a Owner Sig ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLO IDA
COUNTY OF S- Lk n� COUNTY OF iT LU GPI&
Sworn to (or affirmed) and subscribed before me of Sw rn to (or affirmed) and subscribed before me of
Physical Presence Online Notarization
Physical Presence or Online No arization or
this day of by this day of ;T0.[1V by 2CO2
-I-V)0No's L•ya,0,SQ.
Name of person making statement. 'Du5t, in Zw i J C Name of person making statement.
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Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced °roduced
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