HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/21/22 _ Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial
CBDG Funding
PERMIT APPLICATION FOR: Accordion Shutters
PROPOSED I M PROVEM ENT LOCATION:
Address: 8916 Champions Way
Property Tax ID #: 3334-501-0066-000-3
Site Plan Name: Stanley & Darlene Pry
Project Name: Pry Accordion Shutters
DETAILED DESCRIPTION OF WORIG:
Installing 3 Accordion Shutters
ASSA Accordion Shutters Bertha HV1 1850.3
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential X
(Affidavit required)
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 4,872.00 Utilities: —Sewer —Septic
OWNER/LESSEE:
Name Stanley & Darlene Pry
Address: 8916 Champions Way
City:, Port St. Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 561-373-5233 E_
Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lot No. 52
Block No. A
Building Height:
Pond
Pitch
CONTRACTOR:
Name: Michael O'Donnell
Company: O'Donnell Contracting LLC
Address: 1740 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:
Phone No 772-408-0200
E-Mail odonnellpermitting gmail.com
State or County License CRC1331273
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 LIEN LAME INFORMATION:
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name: _
Address:
City:
Zip;
Phone:
Not Applicable
State
X Not Applicable
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name: _
Address:
City:
Zip:
Phone:
X Not Applicable
State:
X Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work.ar 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 holderto build the subject structure
which conflicts with anly applicable Homeowners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consu t 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 pa ed on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender 0r-art:4orne before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
Sworn to (or affirmed) and subscribed before me of X Physical Presence or Online Notarization
this 21 day of January 20 22 by
Michael O'Donnell
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification Produced
�.
(5 gnature Qf Notary Public- State of Florida)
Commission No. (Seal) �PW/j VVinn Allen
Comin.#GG 62
EOW ��2M
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED