HomeMy WebLinkAboutBuilding Permit ApplicationOr 013 pa02(0 / D
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /'�
Date: Permit Number'
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Building Permit App ' ation
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 CBDG Funding
PERMIT APPLICATION FOR:
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t?ROPOSfD IMPROVEMENT LOCATION
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Address: 3100 N Highway A1A - Unit 905
Property Tax lD #: 1425-606-0039-000-0 Lot No.
Site Plan Name: Block No.
Project Name: Ross
INSTALL ACCORD
SHUTTER(S) -
New Electrical Meter Second Electrical Meter (Affidavit required)
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 9960 Utilities: _ Sewer _ Septic.
Building Height:
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OWNER/LESSEE
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"CONTRA fT -OR +�?x ik3t;..4et.
Name Craig & Barbette Ross ; ,- .
Name: -:,--,.-Edward J Heritage
Address: 37 Hillside Terr
Company: , Folding Shutter Corporation
City: Brewster State:,M , ,
Address':": 1862 Dr Martin Luther King Blvd
Zip Code: 10509 Fax: n/a
City: West Palm Beach State: FL
Phone No. 845-667-9891 E-
Zip Code: 33404 Fax: 561-640-8204
Mail: n/a
Phone No 561-683-4811
Fill in fee simple Title Holder on next page (if different
E-Mail info _foldingshutters.com
from the Owner listed above)
State or County License SCC
If value of construction is 2500 or more, a RECORDED Notice of Commencement is
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is requ
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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 g�yrantin a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable HomeownersMociaiion rules, bylaws or and covenants that may restrict or prohibit such
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 attornev before commencing work or recording vour Notice of Commencement.
Signature of Own e ssee or as Agent for Owner
STATE OF FLORIDA
COUNTY OF PALM BEACH
Sworn to (or affirmedLand subscribed befo a me of XX Physical Presence or Online Notarization
1 Ff-b
this day of , 20 by
EDWARD J HERITAGE
Name of person making statement.
Personally Known XX OR Produced Identification
Typ tification Produced
(Signature of Notary Public- State of Florida)
Pamela A. Evans
Commission No. (Seal) NOTARY PUBLIC
STATE OF FLORIDA
*.CommExpires
GG262789
10111/2022
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Rev 572U/4.1