HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABIN O M T BE COMPLETED FOR APPLICATION TO BE ACCEPTED II
Date: rc Permit Number:
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
. PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 5706 Papaya Drive, Fort Pierce FL 34982
Legal Description: Indian River Estates-Unit 09-Blk 79 Kit 6 (Map 34/12N)(Or 1154-465)
Property Tax ID#: 3402 610 0271 000 6 Lot No.6
Site Plan Name: '.S Block No. 79
Project Name: Piscitelli
Setbacks Front Back: Right Side: Left Side:
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Please Call When Ready
561-721-5611
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Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank ❑Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ z/5-36 -
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Utilities: Sewer Se tic Building Height:
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Name David &Teresa Piscitelli Name: Charles J. Stypulkowski
Address:5706,Papaya(Drive Y
Com an Folding Shutter Corporation
Company:
City: Fort Pierce State:F� Acidress;..7089 Hemstreet Place
Zip Code: 34982.: , Fax:..: City:'West Palm Beach'; State:FL
772 260 0562.. 561 640 8204
Phone No: Zip Code:.,. Fax:
E-Mail: Phone No. 561 683 4811
Fill in fee simple Title Holder on next page( if different E-Mail: Info@FoldingShutters.com
from the Owner listed above) State or County License: SCC131150802
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL.,CONSTRUCTION;LIEN LAW INFORMATION:
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: _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 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 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.
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Beach COUNTY OF Palm Beach
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this J_day of TO P--5'f- 20 lZL)y this 1 day of 20 by
Charles J.StypulkoAki Charles J.Stypulkowski
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. FF 15-0 f G? (Seal) Commission No. T--F-1So SG '7 PAMEL(kRr%a9VANS
PAMELA A.EVANe0d NOTARY PUBLIC
NOTARY PUBLICSTATE—IF FLE)RIPA
STATE OF FLORIDA `3 =Comm#FF150967
Revised 07/15/2014WOVExpires
Comm#FF150967 •sNCE Expires 10/11/2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS