HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: °, 5 Permit Number:. 1565 -433
RECEIVED MAY 2.11015
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 Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click here Accordion shutters
-PRbPOS.ED 11N.P.ROV.EWNT;LOCATION
Address: 6731 Gayiota
Legal Description:_Spanish Lakes Fairways Block 38 Lot 23
Property Tax ID#: 1306-500-00 8-000/2 Lot No. 23
Site Plan Name: Block No38
Project Name:
Setbacks "Front Back: Right Side: Left Side:
j.-b-'ETA`;IL'E:D'DES CR[PTI ON OF 1NORK;; Ins:tal:T 'accordion*,`shutters ori
openings of home per di acIram
CONSTRUCTION INFO.R'MAThON - - - ,
Additional work to e e orme under tis permit—check a that apply:
appy:
EIHVAC be
❑Gas Piping Shutters Windows/Doors
a
Electric D.Plumbing oSprinklers El Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:'$ 7, 000 .00 Utilities: SewerSeptic Build ing.Height:
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'Name Larry & Robin Beyi lacQua Name:: Jeff Jackman
Address: 6731 .Gavio.ta.,.. Company: Master Craft. Aluminum Prod.
City.: Fort Pierce State:, FL. .. 'Address: 1634 SE Niemeyer Cir. .
Zip.Code: 34951- Fax: - Gty:. 'State:.FjL.
Phone:No__772-342-2115Zip"+Code: 34952 'Fax. 33.5-0860
E-Mail: Phone No: 35-1177
Fill infee.simple;Title Holder on next page:(if different E-Mail:mastercraf talLmi_nLdmradmail com
from the Owner listed above) State or.County License: a 5 b
If:value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
:, e
S1PPLE]MENTAL CONSTRUCTION LIEN.LA1N-:WFOR:1MATl:ON
.DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY. x Not Applicable
Name.: Name:
:Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:. x Not Applicable BONDING.COMPANY: x Not Applicable
Name: 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 prohibits uch
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'l 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.
Signat e r/. gent/Lessee Signatur=fCr icense Holder
STA. O OR A STATEID
COUN OF St. L'uLci_&-� COUNTY OF SL.. 'I,L7, _e
The forgoing instrument was acknowledged before me The forgoing instrument wasacknowledged before me
this],4,_day of -Ma 20E�by this; day of 20' b
Y' 14. — -P4ay �l y
Jeff Jackman Jef f: Jackman
(Name of.person acknowledging) (Name of person.acknowledging.)
Si nature of Nota Public-State f (Signature.of Nota Public-'State.of•Florida
( g ry Sg-I�����hAOORE ( g Notary )
P.ersonall Known X OTA.Y P gLIC_
y' &e dent Personally KnownVf) > �cType of Identification o` Type of Identificat1 ATEOFFLQ�IDA
Commisson'N0. t9EXPire ��/2016 Commission'No. drhtt�#
Revised 07/1.5/ 014
REVIEWS .;FRONT ZONING. SUPERVISOR
_REVIEW PLANS VEGETATION:—' 'SEA TURTLE MANGROVE
CO:U;NT.ER REVIEW. :R.EUIEIN REVIEW REVIEW REVIEW
DATE
RECEIVED
:DATE
COMPLETED