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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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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 Residential X
PERMIT APPLICATION FOR: Shutter
PROPO,SED.IMPROVEMENT LOCATION:
Address: 9650 S Ocean Dr Unit 505, Jensen Beach, FL 34957-2358
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 505
Property Tax ID#: 4502-610-0045-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Hurricane shutters (accordion type)
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
f Accordion shutters at the balcony area
`CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check all that appy:
HVAC Gas Tank []Gas Piping Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:6,700.00 S Ft.of First Floor:
Cost of Construction:$ Utilities: _Sewer Septic Building Height:.
OWNER/LESSEE: L _ : - `CONTRACTOR:.:
Name Miriam H Hilly Name: Edwing Sosa
Address:9650 S Ocean Dr Unit 505 Company: Edwing's Unlimited Shutter Services, L.L.C.
City: Jensen Beach state:FL Address: 460 NW Concourse Place#16
Zip Code: 34957-2358 Fax: City: Port St. Lucie State:FL.
Phone No.(772)229-2072 Zip Code: 34986 Fax: (772)905-9431
E-Mail: Phone No. (772)370-0766
Fill in fee simple Title Holder on next page(if different E-Mail: ed@edsunlimitedservices.com
from the Owner listed above) State or County License: 28457
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW.INFORMATION4.
DESIGNER/ENGINEER: x_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:
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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_Signature of Owner/Lessee/Agent IrSignature of Con actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
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The forgoing instrument was acknowledged before me The forgoing instr ent was acknowledged efore me
this day of &% 20 j5-by this 10 day of 20 by
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(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known �3roduced Pd i4ld1aA@M Personally Known OR&Pduceldent',�� ication X
Type of Identificatio RT` �: Notary Public-State of Florida Type of Identification Produce U�1�1 YU
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Commission No. �'� � Commission No. L Notaru5ft -state of Florida
PEE Bonded T rough National Notary Assn. A` ' •E My Comm.Expires Sep 25,2015
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Bonded Through National Notary Assn.
Revised 07/15/2014
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