HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5115 Permit Number: ��� —da 13
RECEIVED JUN 15 1015
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: Shutter
PROPOSED IMPROVEMENT LOCATION '
Address: 6540 DULCE REAL FORT PIERCE FL. 34951
Legal Description: 063439 THAT PART OF SEC AS SHOWN IN OR 3538-1033 DULCE REAL AVE(BLK 70 LOT28)
Property Tax ID#: �30�� 11� --(1OdA —aC3(3 ' it Lot No.28
Site Plan Name: SPANISH LAKES FAIRWAYS Block No. 70
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED D'ESCRIPTION'OF WORK: a
CONSTRUCTION INFORMATION: "
Additionalwork to a er orme un er t is permit—c ec a t a appy:
IIHVAC Gas Tank ❑Gas Piping �_Shutters Windows/Doors
FlElectric 0 Plumbing Sprinklers 0 Generator E]Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer ElSeptic Building Height:
OWNER/LESSEE: - CONTRACTOR: -
Name MICHAEL SHERMAN Name: MATTHEW MARKS
Address:6540 DULCE REAL Company: EAST COAST ALUMINUM
City: FORT PIERCE State:FL Address: 913 EDWARDS RD.
Zip Code: 34951 Fax: City: FORT PIERCE State:FL
Phone No.772-242-8160 Zip Code: 34982 Fax: 772-464-7603
E-Mail: Phone No. 772-464-7600
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 24526
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL°CONSTRUCTION LIEWL IN10' i' 6 .— -
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 thepermit 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. 1
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST. LUCI E COUNTY OF 9T: 1.11CI t
The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this day of �f a-ft_ 20 Eby this Z I day of A PP-4L •201S by
MATT-k&W MA"S MTTACW MARK-C
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary PVubli�c-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Knowny OR Produced Identification
Type of Identification Pri iduaefk, ype of Identification Produce
R'''� ;; DONALD M HOLM
Commission No. ` MY 99LMNISSION#EE 12674 ommission No.IF. WA-VOMMISSION#EE1 49
EI✓4Z EXPIRES September 20,201 =,
407 3980153 FlorldeNotaryservke.com , EXPIRES September 20, 15
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Revised 07/15/2014
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