HomeMy WebLinkAboutBuilding Permit Application j L l U " C I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:T` �5 Permit Number: VS0
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial /C6#Jb0 Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:-
Address:
OCATION:Address: 9600 S OCEAN DR#704, JENSEN BEACH FL 34957
Legal Description: EMPRESS CONDOMINIUM UNIT 704 (OR 1982-689)
Property Tax ID#: 4502 620 0049 000 2 A&W Lot No.
X-721-5611
Site Plan Name:_ WHEN READ., Block No.
Project Name: JONES
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONO,FW�ORK.'
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�CONSTRUCTIONINFORMATION � 4s aE Bw
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Additional work to b
� orme under this permit—check a appy:
❑ ff-Z
-HVAC' Gas Pi in _Shutte
Shutters Windows Doors
:❑ /.
Electric ❑ Plumbing Sprinklers ❑Generator D Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
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Cost of Construction:$ "7 a�J• Utilities: _Sewer OSeptic Building He
OUVzNE �LE�SS�EE;z_ � �� �.����'• �k:�� C®NTRACTOR: �r ��� ..
Name HAROLD JONES Name: CHARLES J.STYPULKOWSKI
Address:820 LANE 105 LAKE JAMES Company: FOLDING SHUTTER CORPORATION
City:.ANGOLA ..;..: - State:IN Address:,7.089.HEMSTREET PLACE - -
Fax: -Ci 467031"' Fax: City: 'WEST PALM'BEACH State:FL
Phone fro;260 8.33 2690,;; ,,'Y Zip Code ,;33413 Fax: 561 6408204
E-Mail: Phone No. 561 683 4811
Fill in fee simple Title Holder on next page(if different E-Mail: INFO@FOLDINGSHUTTERS,..G,
from the Owner listed above) State or County License: SCC13115# 2
561-7
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. N REq J
SUPPLEIVIENTALxCO',NSTRIJCTION LIEN LAININgF ° ,RMATI
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:'
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 thegrantingof 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.Zy.�.. S:fik % �.� ,J;" k`� T k" r �01—r- a a• .� • r
Signature ofd ner.Lessee/ nt _� Signature oC ntractor/ c se Holder k b
STATE OF FLORID --rr STATE OF FLOR A
COUNTY OF AI SB?—Ar '1 COUNTY OF �4-cwt- a 6�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this aA day of AIFKi( , 20 Eby this as day of 20 i'57— by
Gharl®s J. &WulkoyMd MWiM J. Stypulk
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Publ-State of Florida) (Signature of Notary Pu c-State of Florida )
Personally Known 1// OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. F I,O ON7 (Seal) Commission No. (Seal)
PAMELA�tARY�sso� NOTARY A.
EV C S �o1PY,�y,o PAMELA A.EVANS
s NOTARY PUBLIC
c =STATE OF FLORIDA « =STATE OF FLORIDA
Revised 07/15/2014 W =Comm#FF150967 ?Comm#FF150967
��NCE 19 Expires 10/11/2018 s1NCE 1r Ex ires 10/11/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS