HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO,MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G
Date:f- q — Imo' Permit Number: V O (0 0 q
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 Shutters
P:ROPOSE 0.1N.ROVEM:ENT:L'OCATIO:N_
Address: 20 San Luis Obispo Fort Pierce
Legal DescriptionSpanish Lakes Country Club Village Leasehold Estates
Lot 20 San Luis Obispo
Property Tax ID#: 1301-500-0952-000/0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DE AILED;DESCRIPTION OF VIIORK:: Install :accordion_: shutters to eight
cippnigns on the home
CO NSTRU CTI.ON iI NFORt
lUTATI(J N
Additional work to be Derformed under tis permit—check all that appy:
HVAC Gas Tank Gas Piping FX1 Shutters Q Windows/Doors
Electric :PlumbingSprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 5,000. 00 Utilities: Sewer Septic Building Height:
;.•.
y§7 r�Y ttrta7 a`
i n �I�CM�2��� , L>. $•. d.' �.9 .r:�� tS:t` �t{tY,ie'ufl��Ynl�+�'.yT�..1 ����� � � � ..nL S�+Y✓•r� _
'Name ThnmaG R Carnl �1 i vi n.Gk Name: Teff .Tar.kman
Address: 20 San Luis Obispo Company: Master craft: Aluminum Prod.
City.: Fort Pierce State: FL Address: 1634 -SE Niemeyer ,.Cir.
ZiwCode: 34951 Fax.'
-City,: St. Lucie State: FL
Phone:No.. 242-1959 Zip:Code: -34952 Fax: '335-1177
E-Mail: Phone.-No. 335-1177
Fill infee simple Title Holder on.next page[if different E=Mail:.mn gtPrcra f i-a l nmi-nnm[agma i 1 _(-r)m
from the Owner listed above) State:or County License:.,SCC l 31 1 S o S R h
If value of constructionis$2500 or more,a RECORDED Notice of Commencement is required.
V.1
SUpFIMENTAL CO:NSTRCTiDN L1E:N LA'W INFC}RMATiON. ..
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 priorto 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 Horne 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 BuJiding 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 yourrpaying 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.
Sign u 0 rjAgentJ Lessee Signa re f cnt c or/License Holder
ST FL DA STATE O OR A
i
COUNTY OF St. Lucie COUNTY OF S T.t?cje
The forgoing instrument was acknowledged before me The forgoing instrument was,acknowiedged before me
this�day of ,Iu11r20f'by this --'day of, dI� ' 20by
z
Jeff Jackman TPff Tack an
(Name of person acknowledging) '(Name of person acknowledging.)
(Signature of Notary Public-State of,Fiorida';} _ _(Signature of Notary..Pubiic-State.of Flori }ERYL D MOpRE
P,ersona!!y'Known X -j&ec
� tiYitiRE Personally-Known x O.Type of Identification RroduNOTARY PUBLIC- T.ype of Identification Produc � amityTATE OF FLORIDA
BTATE6F FLORID �� otntn#EE156461
Commission No. g9WEE156461 •Commission'No. F top
1/15/2016
Expires 1/1512016
Revised`07115/207.4 ,
REVIEWS FRONT ZO:NiNG SUPERVISOR PLANS VEGETATION SEA TURTLE . `MANGROVE
COUNTER REVIEW REVIEW. REVIEW REVIEW, REVIEW. 'REVIEW
.DATE -
::RECEIVED
.DATE
:COMPLETED .