HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �� ��
Date: Permit Number: I!
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 I NI PRVEM ENT LOCATION .
Address: 13525 S INDIAN RIVER DR 104,Jensen Beach,FL 34957
Legal Description:INDIAN RIVER LANDING BLDG 1 UNIT104 AND UNDIV SHARE IN COMMON ELEMENTS
Property Tax ID#:4509-804-0004-000-0 Lot No.
Site Plan Name: Block No.
Project Name:Steven,Joan&Jennifer Campbell
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
,
Replace 4 Windows �,Q ��/Q�,C7 `C . 55
to_ S.TRU,CTIQW,IN;FORMAT.IO
�Na
itiona wor to a er orme under tis permit-check all tha appy:
OHVAC Gas Tank ❑Gas Piping _Shutters E]Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 5000 Utilities:0Sewer Septic Building Height:
OINNERf LESSEE_
CONTRACTOR
Name Steven,Joan&Jennifer Campbell Name:Dan Beckner
Address: 13525 S INDIAN RIVER DR 104 Company:Paradise Exteriors,LLC
City: Jensen Beach State: FL Address:1918 Corporate Drive
Zlp Code: 34957 Fax: City:Boynton Beach State:FL
Phone No. (P l `�1�. _-7 Z-33 Zip Code: 33426 Fax:866-721-5332
E-Mail: Phone No. 561-732-0300
Fill in fee simple Title Holder on next page( if different E-Mail:paradiseexteriorsllc(a,gmail.com
from the Owner listed above) State or County License:SCC131150472
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL C0NSTR'.,UCTION'LJEN LAIN INFC3RMATIaN:„
,
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 Count 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 covenantsthat 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 Codesand 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,screenrooms 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.
Slgnat of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLOR��pp
COUNTY OF �+ . j_tA C)1= COUNTY OF •4 M
The forgoing instrument was acknowledged before me The f Ing instr ent was cknowledge before me
thisl; day of_ A APP Q 20 jt by this day of GUi 20by
I P(fckw�
fel�►.I �.a�n Pte-, � E
(Name of person acknowledging) (Name of perso cknowledging)
(Signature P
otary Public-State of Florida} nature of No Public-Sta Florida}
Personally Known / OR Produced Identification Personally Known �� Produced Identific n
Type of Identification Produced Type of Identification Produced
o�
Commission No. JANU%ei�WELL Commission No. (S gal c����9
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Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA f{ J�°` ATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIE REVIEW REVIEW
DATE
COMPLETE
=INITIALS