HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ 2/21/22 Permit Number:
Ll�"L LLGLJ LP
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding
PERMIT APPLICATION FOR: Accordion Shutters
PROPOSED IMPROVEMENT LOCATION:
Address: 18 Lake Vista Trail #201
Property Tax ID #: 3422-500-0246-000-6
Site Plan Name: David Pineda
Project Name: Pineda Shutters
DETAILED DESCRIPTION OF WORK:
Installing 6 Accordion Shutters
Bertha HV Accordion Shutters 1850.3
New Electrical Meter Second Electrical Meter
r�ONSTRUCTION INFORMATION:
Lot No.
T Block No.
(Affidavit required)
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 Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 3,988.00 _ _ _ Utilities: _ Sewer _ Septic
❑WNERAESSEE: CONTRACTOR:
Building Height:
Name David Pineda Name: William H. Miller
Address: 18 Lake Vista Trail #201 Company: O'Donnell Contracting LLC
City: Port St. Lucie State: FL Address: 1740 NW Federal Hwy
Zip Code: 34952 Fax: City: Stuart State: FL
Phone No. 708-557-4255 E- Zip Code: 34994 Fax:
Mail: Phone No 772-408-0200
Fill in fee simple Title Holder on next page (if different E-Mail odonnellpermitting_gmail.com
from the Owner listed above) State or County License CGC035934
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 LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
_
Address:
_
City: State: _ _
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 uses to another non-residential use
�oomsmet�l'accessory
WARNING TO OWNER: Your failure to Record a Notice ofncementmay result in paying twice for
improvements to your p-rpperty. A Notice ifnencement must be recorded in the public records of St.
Lucie Cou y and p9sfeed/on the jobsite bee first inspection. If you intend to obtain financing, consult
01nR
with le or a tta Ke before comm ork or record in , yaur Notice of Commencement.
gnat e,d Owner/ e Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Martin
r affir d and subscribed bef r me of X Physical Presence or Online Notarization
SwOday
ti of 2�y
William H. Miller
Name of person making statement.
Pers nil Known. X OR Produced Identification
Typ. I tification Prod ti d
(SI gfi ature otary Public- State of Flom a)
Wynn Allen
Commission No. (seal) Comm.#GG366562
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COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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