HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
OUANNED
BY RECEIVED
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Building Permit Application JUL 0 2 2-T8
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of lineSln
PROPOSED IMPROVEMENT LOCATION:
Address: 4100 N HIGHWAY A1A UNIT #112
Legal Description: TREASURE COVE DUNES UNIT 112 (OR 3549-608)
Property Tax ID #: 142350200020007
Site Plan Name: WILLIAM DENOYER
Project Name: WILLIAM DENOYER
Setbacks
Back: Right Side:
Left Side:
INSTALLATION OF HURRICANE SHUTTERS - THREE (3) OPENINGS/ACCORDION
J Gas Tank
0 Plumbing
Total Sq. Ft of Construction: _
Cost of Construction: $ 1,711.62
Lot No.
Block No.
Jul wain oil apply.
Sas Piping `f Shutters ❑ Windows/Doors
Sprinklers 11 Generator E]Roof
S Ft. of First Floor: _
Utilities:ll Sewer D Septic
Building Height:
Roof pitch
`OW,NER%LESSEE
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CONTRACTOR:
NameWILLIAM DENOYER
Name: MIRIAM VAN TASSEL
Address:4100 N HWY A1A
Company: DVT HURRICANE SHUTTERS, INC.
City: FORT PIERCE State:FL
Zip Code: 34949 Fax:
Phone No.231-632-2670
Address: 3100 N KINGS HIGHWAY
City: FORT PIERCE State: FL
Zip Code: 34951 Fax: 772-794-1590
Phone No. 772466-4575
E-Mail: williebump@hotmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: dvthurricaneshuttersinc@hotmail.com
State or County License: 24394
if value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
11
SUPPLEMENTAL CONSTRUCTION LIENAA INFORMATION_
DESIGN ER/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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded 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.IK
Rev.8/2/17
Signatur f Owner/ Lessee%Contractor as Agent for Owner
Signature ontractor/License Holder
of
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 6�-. N.Oc
COUNTY OF s�'-
The forgoing instrument was acknowledge before me
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The forgoing instrument was acknowledged before me
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this � day of �yk y . 20 by
this � day of 20 by
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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
Produced
Produced
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DATE
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COMPLETED