HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-r
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,6 r SCANNED Permit Number: fq(IQ-Da( n
BY
�qp-M � _i ff -1 St. Lucie Counn
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
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Building Permit Application
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Y
Commercial N� Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATION: 3200 N Highway A1A Unit 1110
Address: 3200 N Highway A1A Unit 1110
PropertyTax ID #: 1425-600-0106-000-3
Site Plan Name:
Project Name: Barbara Grange
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
"6—it411 00.0 Shu
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping ✓Shutters -Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ "'?8—
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Barbara N Grange
Name: Edward J. Heritage
Address: 3200 N A1A Unit 1110
Company: Folding Shutter Corporation
City:_ Hutchinson Island State: _
Zip Code: 34949 Fax: NIA
Phone No. 740-819-0537
Address:1862 Or Martin Luther King Jr Blvd
Cify:'West Palm Beach State: FL
Zip Code: 33404 Fax: 561-640-8204
Phone No 561-683-4811
E-Mail: NIA
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."
I ha uteofOwn' _ e-asAgentforour 'er
ignatureof'Conlr Y/Eice - er'
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm 9aadi
COUNTY OF Ph Beach
The for�oing instrument was acknowledged before me
this2 day of Suu� 20-4by
The forgoing instrument was acknowledged before me
thisa( dayof
20/Jby
Edward J. Heritage
Edward J. Heritage
Name of person making statement.
Name of person making statement.
Personally Known xx OR Produced Identification
Personally Known xx OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
®® //
(Signature of Notary Public -State of Florida)
,mot P" Pamela A. Evans
(Signature of Notary Public -State of Florida )
Commission No.U�'��?� °'"'` to OTARYPUBLIC
_ 'r
o�p A Pamela A. Evans
Commission No.67_&A( �? S9 °' }NARY PUBLIC
sk;;;. o TATE OF FLORID
r, Comm# GG262789
aQ =STATE OF FLORID
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Expires
10/11/20
2
sNce10
i 10/11/20
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