HomeMy WebLinkAboutBUILIDNG PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: O' IS 1111111111111h�OC SCANNED permit Number: 0
BY
"— St. Lucie County =RECEIVEDBuilding Permit ApplicationPlanning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial C-Dv(b Residential
PERMIT APPLICATION FOR: Window/door III
EDIMPROVEMENT
Address: Oc;dW ty A -IA `3Ubl roi'7 N{erG'ei
Legal Description: SEA PALMS UNIT 806 AND PRO=RATA SHARE IN COMMON ELEMENTS (OR
Property Tax ID #: 1425-600-0072-000-5
Site Plan Name: SMITH
Project Name: SMITH
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
5 4uJt sLs
CONSTRUCTION INFORMATION: III
LJHVAC LJGas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ .!5'_% a�
Piping Lr lShutters
nklers E] Generator
S Ft. of First Floor: _
Utilities:nSewer D Septic
QWindows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
_
L ' tk
Address:'3'o11�6 N ltt64.tw-[A- 80(o
_�c�YP�
Company "FOLDING SHUTTER CORIP -
City:, t" =i =- BtYYe -- : State: FL
Zip Code: 34949 - "Fax: "
Phone No. 772-473-7413
1A dressi»089:HEMSTRLET PLACE
tCitytPS1''=T o�y r� 3,A eJ , State: FL
33413 `er ; ' ^ 561-640-8204
Zip Code: s> Fax:
Phone No. 561-640-8204
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: INFO@FOLDINGSHUTTERS.COM
State or County License: SCC131151041
If value of construction is $2500 or more, a RECORDED Notice of commencement Is required.
SUPPLEMENTAL CONSTRUCTION LIEN. LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
Not Applicable
Address:
Address:
City: State:
Zip: Phone'
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: 17 Not Applicable
Name: !i
BONDING COMPANY:
Name:
ACNot Applicable
Address: 7089 HEMSTREET PLACE
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 your Notice of Commencement.
'Signature of Owner/ L ssee/.0 nt for Owner
Signature of Con eeteykieense
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF PALM BEACH
COUNTY OF PALM BEACH
The foraoing instrument wasnowledge efore me
7 j�6t�A+«'L 1
The fo oing instrumenPt was a knowledge before me
this day of f"c+d'c 20 by
this C. 20 by
EDWARD J HERITAGE
EDWARD J HERITAGE
Name of person making statement
Name of person making statement
Personally Known boc OR Produced Identification
Personally Known xxx OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
Y� � . �
/�
�li+� 'C
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida) EVANs
E'A A
Gj�(i0 iL %
Commission No. l (Seal) A EvpNS
Pr U130C
Commission No. FVt � NOT Y pLOR10A
PAMEIA �UsLlc,
v10500 67
NOTAR
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REVIEWS
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PLAN
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SEA TURTLE
MANGROVE
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REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED_/3
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Rev.8/2/17