HomeMy WebLinkAboutBUILDING PERMIT APPLICATION1 �
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: IIZIl1S SCANNED Permit Number:
BY RECEIVED
St. Lucie County
Building Permit Application[APP% 12 2018
Planning and Development Services Coun
Building and Code Regulation Division tY, Permltttng
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential A
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S huff erj
f PROPOSED IMPROVEMENT LOCATION:' I
Address: 3300 N HIGHWAYA1A, Fort Pierce, FL 34949
Legal Description: 25/26 34 40 GOVT LOT 1 IN SEC 25AND GOUT
LOT 1 IN SEC 26 ALL LYG EOF A1A (20.36 AC) (LEASE AGR #3370)
Property Tax ID p: 1425-220-0001-000-1 Lot No.1
Site Plan Name: Navy Seal Museum Block No.
Project Name: Navy Seal Museum
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK; �II
Installation of One (1) Nautilus Rolling Shutter Hurricane
CONSTRUCTION INFORMATION;
rtiona wor to e e orme under tispermit—check all apply:
❑HVAC Gas Tank Gas Piping Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator EI Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 3,562.79
S Ft. of First Floor: _
Utilities:cn Sewer O Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameTr Int Imp Trust Fund
Name: Miriam Van Tassel
Address:3900 Commonwealth Blvd
Company: DVT Hurricane Shutters, Inc.
City: Tallahassee State:FL
Zip Code: 32399 Fax:
Phone No.772-595-5845 Ext 204
Address: 3100 N Kings Highway
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 772-794-1590
Phone No. 772-794-1581
E-Mail:lisa@navysealmuseum.org
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.
\illt
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
Name: Tr Int Imp Trust Fund
Address: 3300 N HIGHWAY AIA, Fort Pierce, FL 34949
City: Tallahassee State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 3100 N Kings Highway
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name: Miriam Van Tassel
Address: 3900 Commonwealth Blvd
City: Fort Pierce State:
Zip: Phone:
BONDING COMPANY:
Address:
to
_Not Applicable
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.
Signaturq of Owner/ Lessee Contractor as Agent for Owner
Z0
Signature ofntractor/License Holder
/FLO!n
STATE OF FLORIDA
STATE OF
COUNTYOF
COUNTY OF
The forgoing instrument was acknowledge before me
cl'tt'C\ A
The forgoing instrument was acknowledged before me
°l
this %Q dayof 20 by
thisday of Ri' %\ 20L by
V\""r\A N V0'VN Ti0.66e.1
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identifica?Nn
Type of Identificaion t
Produced T L 'D i
Produced �'r L�(t%}�1
(Signature of Notary Pu lic- State of I'l
(Signature of Notary Pu lic- State of lo�da he n+ -T+
' ANNAMFRIE GNEIN I
Commission No. ,•' '°: MY 'dAISSION#GG 071023
, •.,r,'+=
��. 2020
-;ilnb DEANNAMARIEGIVENS
Commission NO. •Y'ei YCOMIdISg�aI�G 022023
-'.r p�(pIRES: December 16,
,. -*• . �_
- ;._ EXPIRES: December i6, 2020
:a tlNaN publicUnderndters
0` BondedTlw'
o Banded ThN Notary PubfeUnderviAler+
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17