HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 5300 INDIAN BEND LN FT. PIERCE F
Property Tax ID #: 1312-800-0002-000-1
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
install 12 accordian shutters
34951
New Electrical Meter Second Electrical Meter (Affidavit required)
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping VShutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name MARY CARESS
Name: thomas L pease
Addres§300 INDIAN BEND LN
Company: florida shutters inc.
City: _ FT. PIERCE State: FL
Zip Code: 34951 Fax:
Phone No.925-518-1037
Address: 1055 commerce ave
City: vero beach State: fl
Zip Code: 32960 Fax:
Phone No 772-569-2200
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License cbc015453
vu — vi V 1J'I ULLIU[i ID fJVU UI III UIe, d RCI.VPCVCU rvance of Commencement is required.
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 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: 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.
Signature of Ow er/ Lessee/Contractor as Agent for Owner
STATE OF FLORI ,
COUNTY OF S
Sworr�to (or affirmed) anA subscribed before me of Physical Presence or Online Notarization
day
this Islill. of 20Q ( by
Name of person making statement.
Personally Known OR Produced Iden ' ication
e of Identification Prod uced — L—
(Signature of Notary Public- State of Florida ) ......
i�Y DEBORAH EMERICK
Notary Public
- State of Florida
Commission No. (Seal) Commission p GG 952084
's'oFc�
My Comm. Expires Mar 20, 2024
Bonded through National Notary Assn,
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DATE
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Rev 5/20/21