HomeMy WebLinkAboutApplication.pdfAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number'
hl Building Permit Application
Planning and Dev,-Op rent Services
Burdirlyand Code Rego +otionDivWon Commercial Residential
2200 Virgirrio Avenue, Fort Pierre FL 34282
Phone; f 772j 462-1553 Fax: (772) 462-1578 CI3DG funding —
PERMIT APPLICATION FOR: Hurricane Shutters
Address: 7028 Willow Pine Way R -T
Property Tax ID #; 3322-1521-0052-000-4 Lot No. 43
Site Plan Name:
Project Name: Malaska
[DIT fLED DE MOTION OF WORK:
Install 8 accardian shutters - —
New Electrical Meter Second Electrical Meter (Affidavit required)
i CONSTRUCTION INFORMATION -
Additional work to be performed under this permit - cherR all that apply,
Mechanical
— Electric
—Gas Tank
Plumbing
Total Sq. Ft of Construction-.
Cost of Construction: 5 4,188. 03
NE
— Gas Piping
__ Sprinklers
Eloi* No.
Shutters Window5fpOors Pond
— Generator Roof _ Pitch
Sq- ft- of First Floor -
Utilities: — Sewer , Septic Building Height:
Narne Gear e & Maureen Malaska _ Name; Mich I eissent} fi
Address; 7028 UYlfnw Pine Way Company; Expert Shutter Services
Cam. Port St Lucie State, FL Address; 668 SVV Whitmore Drive
Zip Code; 3406 Fax; _ _ City: Port Saint Lucie _ State. FL
phone No, 16-374- 531 F- Zip Code- 34984 Fax:
Wil: Phone No772-871-1915
FRI in fee simple Title Holder on next page (if different E-Mail` permits a expertshutters. corn
from the Owner listed above) I State or County License 16572
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 ComrnPncement is required.
DESIGNEIIANGINEER: Not Applicable I MOFITGAGE COMPANY: Not Applicabie
Name. Tiltetfi.lnt. Name:
Address: 15s r+sslr s.ikaoF Address: _
City: Virginia GaroE59 State_ ri 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/ CDNTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and instal Iation as indicated,
I certify that no work or installation has commenced 13r1iar to the issuance of a permit.
5t. Lucie County makes no representation that is rantin a permit will authorize the permit holder to build the subject structure
which conflicts with an applicable Homeowners Association rules, bylaws or and cgvenants that may restrict car prohibit such
structure- Please con Su. t with your Homeowners Association and review your deed for any restrictions which may apply.
it consideration of the granting of this requester) 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 cancurrency review; room additions,
accessary 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 playing twice far
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted an the jobsite before the first ilispection. If you intend to obtain financing, ton5ult
with lender or an attornf3Lbefore commencing work or recording yoE3r Notice of Commencement.
Signature of Owrerf LesseefContra��Ag,�rltfor Owner
STATE OF FLORIDA
COUNTY OF !St. Lucie
5wofn pia (or affirmed) and subscribed before me of x Physical Presence or Online Notarization
this_ day of iglaf 2U�! JJ by
Michael Heimenterg
Name of per-5on making statement,
Personally Known x OR Produced Edentifica#ion
Typa�of Identification Produced
(Signature of Notary Public- 5tafie of Fbrida)
5E4anot� O'#tea
Commission No. GC,259039 (Seal) NOTARY PUBLIC
STATE OF ELDERIDA
Comm* OG258033
*.Expires
all 212022
REVIEWS FRONT " ZONING SJPERV15OR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE --
RECEIVED
DATE
COMPLETED
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