HomeMy WebLinkAboutBuilding Permit Application ALL APPLI B E INFO M S7 COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
o _
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
PERMIT APPLICATION FOR: Shutter
PROPOSED,.IM PROVEM.ENT LOCATION:,
Address: Ll 2 Co 6C Y I 3
Legal Description: e;UP-rri'L _67-
Property Tax ID#: ��i �_! - 5'�(� `ht � -(�(rY� - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit-check all appy:
11
HVAC Gas TankE]Gas Piping _Shutters a Windows/Doors
Electric Plumbing Sprinklers E Generator 1:1 Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ �U1 /�[�.. Utilities: _Sewer E]Septic Building Height:
OWNER/LESSEE: . CONTRACTOR:
NameName:
r-
Address:,'!)6_ ! SCJ �2te"-'-2 ��-• Company: cT!< Ex
City: 4&- State:FL Address: Jo?D/ ,5/� '/h%��f� S1'•
Zip Code: Fax: City: �� ( a State: FL
Phone No. Zip Code: Fax:
E-Mail: Phone No. -7707 -V?;3 -D(0 06
Fill in fee simple Title Holder on next page(if different E-Mail: ro-) x
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SlJ`PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATI®N
_
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:
1 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.
"4&JI— s
Si ature of Owner/Lessee/Agent Signature of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5T_ GAciP COUNTY OF S L✓,t«
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 31 day of /M411Gf7 20/Lby this�day of 11�A�h .20 L& by
Jonexrl , 411 lhwold
(Name of person acknowledging) (Name of perso cknow edging)
(Si atu of otaVhl Pu tate of Florida) ( ' na r of ry Pul3l tate of Florida)
Perso Known t/ P oduced Identification er ally Known 1/ r e Identification
Type of Identification Prod Type of Identification Prod ed,.�e,.
yp 00 Notary Public State or Florida ;P�'��cn ° n'Public State of Florida
Commission No. M$§o_V Shane Alberico ommission No. � My Cb�on Ene E e2jco
f ommission EE 827424 °�ti Expires 08/16/2016
orr► Expires 424
08/16/2016
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS