HomeMy WebLinkAboutBuilding Permit Application Ica l'0_0l5C1
ALL APPLICABLE INF M-UUYr BE COMPLETED FOR APPLICATION TO BE ACCEPTED r �r L9011
Date: oCf� Permit Number: �J I 0
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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 COn'll'1'lercial Residential x
PERMIT APPLICATION FOR: Shutter
PRO.POSED.IMPROVE-MENT LOCATION:
Address: 13951 Amarilis Ave, Fort Pierce, FL 34951
Legal Description: Spanish Lakes Fairways (13951 Amarilis Ave, Fort Pierce, FL 34951
Property Tax ID#: d n — _ L wu: 1 5 s l
Site Plan Name: Ili(-P5 Block No.
Project Name: Hemingway
Setbacks Front Back: Right Side: Left Side:
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CONSTRjIJCTI®N IN'F®R11/IATI®N������y _ �' �
rtiona wor to e e orme un er t is permit—c
eck all appy: z
In
❑HVAC Gas Tank Gas Pi in Shutters Windows Doors
❑Electric ❑ Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: Scl. Ft.of First Floor:
Cost of Construction:$ (J Z D "=� Utilities:0 Sewer❑Septic Building Height:
®1NN.ER/LE=�S'E.EE;
Name William M&Frances E Hemingway Name: Edward J Heritage
Address:13951 Amarilis Ave . Company: Folding Shutter Corporation
City: Fort PierceState: FL Address: 7089 Hemstreet PI
Ziotode: '34951. Fax: City: West Palm Beach State: FL
Phone No.772-579-5053 Zip Code: 33413 Fax: 561-640-8204
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: SCC131151041
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL,CONSTRUCT.IONL'I'EiN'LA'W°INFORMATION `
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: = 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 OwnoLLesse Signature of Contr etor/Licen er
STATE OF ATE OF FLORIDI
COUNTY OF FLORIDA,N��rn COUNTY OF - Ivy ��oc�c�1
The forgoing instygent was acknowledged before me The forgoing instrument was acknowledged before me
this 1 V day of QJ e64AGr/ 20 /s"by this ru day of AJ 7 J k/,20/5– by
(Name of erson acknowledging_)— (Name-of-person acknowledging_)
Signature of ota ic-State of Florida) (Sign re of otar f F i a
Personally Known Q OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.� S Commission No. V2"r�
I vl D WAD7Flo2riodla,
rJl yam, (Seal*DAM D WADLER
Notary Public-Stat ,'`` s`�^ Notary Public State of Florid
r = ?��' •E Comm.Expires Oct 10.20
s.,.° `o; Commission# EE 842433 r =N.• `oz: Commission#E
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Revised 07/15/20 „ ,
'%t;; ;°p` Bonded Through National Nnlary Assn, °`"' ' Bonded Through National Notary Ass
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