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AiIA'PPIA BLE INFO MUST`BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
an Permit Number:�� �b
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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:
PROPOSED IMPROVEMENT LOCATION:
Residential
Address: 3100 N Highway A1A - Unit 405
Property Tax ID #: 1425-606-0009-000-1 Lot No.
Site Plan Name: Block No.
Project Name: Genel
DETAILED: DESCRIPTION IF WORK
INSTALL ACCORDION SHUTTER(S) - l
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 XShutters indoWs/,
.-: ,I ! c roDoors, Pond
— Electric — Plumbing — Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 7394
Sq.-Ft. of First Floor:
Utilities: —Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Viktor and Elena Gene[
;Name:'` :-Edward J Heritage
Address: 12 Cabot St ';'Company.,Folding
Shutter Corporation
city: Natick . tate:: � X i,_,
Ad'dress' 1862 Dr Martin Luther King Blvd
zip code: 01760 Fax: n/a
city: West Palm Beach State: FL
Phone No. 508-451-5071 E-
Zip Code: 33404 Fax
Mail: n/a
Phone No 561-683-4811
Fill in fee simple Title Holder on next page (if different
E-Mail info@foldingshutters:com -v
from the Owner listed above)
State or County License SCC131151041
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.
Name: _
Address:
City: _
Zip:
Phone
State
MORTGAGE COMPANY: Not;Applicable
Name:
Address:
City: State:
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 conflicts with any. applicable Homeowners Association 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 recordina vour Notice of Commencement.
Signature of Own r e/Contrac as Agent for Owner
STATE OF FL RIDA
COUNTY OF PALM BEACH
/
Sworn to (or affirmed a d subscribed before me of
L Physical Presence or Online Notarization
this day of 20,j by
;�
Wa
,.Heritage;,.�
Name of person making statement.
Personal Known I OR Produced Identification
Typ of Id tification Produced
(Signature of Notary Public- State of Florida)
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Pamela A. Evans
Commission No. (Seal) o
NOTARY PUBLIC
STATE OF FLORIDA
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COMM# GG262789
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Expires 10/11/2022
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