HomeMy WebLinkAboutBUILDING PERMIT APPLICATION` 6 wn0.2r2ia6mG
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 S A41-11"100 ejoq -.IS Permit Number:
Ike
03NNVOS
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Building Permit
MAY 16 2019
Lucie Cowncy,
Commercial lc�( Residential
PERMIT TYPE: Shutters' C dhaa
PROPOSED IMPROVEMENT LOCATION:
Address: 9950 S Ocean Dr#1701, Jensen Beach, FL
Property Tax ID #: 4502-703-0072-000-6 Lot No.
Site Plan Name: Block No.
Project Name: Edda Keuchel
DETAILED DESCRIPTION OF WORK:
.S(hJT/ls5-
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ hutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ % 0, % / Utilities: _Sewer _Septic
—Windows/Doors -
Roof Pitch
Building Height:
OWNER/LESSEE: . =
CONTRACTOR:
Name Edda Keuchel,
Name: Edward J. Heritage "
Address: 9905 S Ocean Or #1701
Company: Folding Shutter Corporation
City: Jensen Beach State: _
Zip Code: 34952 Fax: N/A
Phone No.330-329-8001
Address:1862 Or Martin Luther King Jr. Blvd
City: West Palm Beach, State: FL
Zip Code: 34952' " , •, Fax: 561-640-8204
Phone No 561-683-4811
E-Mail: eddak.2011@gmail•com
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.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-"
5 nat`Lure-oltContiactocLFi�ens�HSf der
ESignature- of -Ow nerAX6ssee n actoca
f genI!gcOwner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm Beach
COUNTY OF Palm BeaO
The for oing instrument was acknowledPP before me
this dayof� 20t by
The forggoing instrument was acknowledged before me
t3dayof YkA-7
this 2017 by
Edward J. Heritage
Edward J. Heritage
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Prod, ,� tification
Type of Identification
Type of Identification
Pro
Produ 02'o
7d
�a. dl,0h
(Signature of Notary Public- State of Florida �
Signature of Notary Public -State of Flori 4' Op G�
�PVassoo 'CPS�4GG2 A'
Commission No. �7'l+• '� 9
70,{6'?O'P7
Commission No. G-G.�G?? �4 (sea ;>, �9
a� Go s1G11
ExQ� t
o22
o �m
'SINCE
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
nev. G///J.7