HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: .SIlQ.6 SCANNED Perma'Number: `�drJ-oki-I.S
BY
St. Lucie Countv
RECEIVED
_. __ •'______ __ -- __... Building Permit ApplicatiCnMAY 2 0 ?Ot9Planning and Development ServicesBuilding and Code Regulation Division e County, Permltting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial o—Nit,— Residential
PERMIT TYPE: S
PROPOSED IMPRO.VEI ,FNTaTQCATION: •. - . :gym • t„ ;t
Address: 11000 S Ocean Drive 4-B, Jensen Beach, F134957
Property Tax ID q: 4512-701-0046-000-0 Lot No.
Site Plan Name:
Project Name: Mike
Block No.
rr. r..rw. - ".,..l �!! llVll�. VI tlY VA\I\. �! `^:. ::. . • _.
Installation of Hurricane Protection o L/!J C
Additional workto be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_,Electric _Plumbing _Sprinklers _Generator _Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 4,315.63
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
Pitch
'OWNER/ LESSEE:,I m`
CbNTRACtOR:'
Na meMike Coulon
Name: Robert Altino
Address:43 Frank Street
Company: Galeforce Hurricane Shutters, inc.
City: Lindenhurst State: NY
Zip Code: 11757 Fax:
Phone N0.631-988-1645
Address:1429 SE Viliiage Green Drive
City. Port St. Lucie State:F1
Zip Code: 34952 Fax:
Phone No 772-337-6200
E-Mail: mcoulon@optimum.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
'E-Mailgaleforcetc@gmail.com
State or County License CBC1251430
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, LAUD IN
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.
Inconsideration 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-A+FQRNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
' nature of wner/Lessee/Contractor as Agent for Owner
S' re of ntractor/License older
STATE OF FLORIDA
STATE OF FLORIDA
1
COUNTY OF Ste. `V C\C
COUNTY OF 6A., L
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of `ln—_, 20 t9 by
this day ofwgl—� 20_1� by
� o moo, c -'r V `O
�' 6D e l �11 \ N_ a -------
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 Identiatio
b
Produced V L. -----
Produced—
r
(Signature of Notary P lic-State of Florida) .
Signature of Nota Ay at C°
Commission No. a.9� �x°.•'• DEANNAMARIEGNEIS
'`?c:�Sea
Vh :•�•o_ EXPIRES: December 1G, 2020
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yI5510n N0. dThru Not 'd�i�;, Uncertmi�rc ;�
EXPIRES: December
ota Pehl'ti Un
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Rev. 217/1