HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED PPO
�Date: 1"1 J12022 Permit Number.
RECEIVED
��o b�C�IlL MAR 0 3 2022
° ' Building Permit Application P"'11 ,1unty
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPLICATION FOR: HURRICANE SHUTTERS
PRO'POSEDIIVIPRRO:VEMENT LOCATION: "- "
Address: 5011 KILLARNEY AVE FT. PIERCE, FL 34951
Property Tax ID #: 1301-615-0148-000-4 Lot No.
Site Plan Name: ROBERT DOOLING 4 LLC Block No. 174
Project Name: - ROBERT DOOLING 4 LLC
.DETAILED.DESCRI'PTION OF WORK: ,
INSTALL SIXTEEN (16) HURRICANE ACCORDION SHUTTERS
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION: ,
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
i orai z)q. ri oT Lonsirucvon:
Cost of Construction: $ 7,955.58
-)q. rt. oT rirsi rioor:
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name ROBERT DOOLING 4 LLC
Name: MIRIAM VAN VASSEL
Company: DVT HURRICANE SHUTTERS, INC.
Address: 5011 KILLARNEY AVE
City: FT. PIERCE State:/
Zip Code: 34951 Fax:
Phone No. 772-460-6240
Address:3100 N. KINGS HIGHWAY
City: FT. PIERCE State: FL
Zip Code: 34951 Fax: 772-794-1590 ,
Phone N0772-794-1581
E-Mail dvthurricaneshuttersinc@hotmail.com
State or County License24394
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above) !
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: _ 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 Owner/ Lessee/Contractor as Agent for Owner
Signature of C ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA (n//
COUNTY OF C �z a "" / -9,
�
COUNTY OF J- / b-C_ -0—
Swofr(to (or affirmed) and subscribed before me of
Swo to (or affirmed) and subscribed before me of
sical Presence or Online Notarization
Physical Presence or Online Notarization
thisPh day of T2b • 202 y
this � day of jr� 202OLby
,",q�,a Wt
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produ d
Produc d
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16,
(Signature of Notary P c- f i 9SION # GG297846
(Signature of Notary Ali airy COA ISSION # GG297846
Commission No. , •• � EXPI I April 29, 2023
Commission No. '''� � :�� EXPIVfpJ6Pr1I 29, 2023
gy,`` Bonded Thru Aaron Notary
�� BondAaron Notary
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