HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �11 ��6 Permit Number:
• r;,� RECEI!„"D APR 0 7 2096
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 xx
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 9424 Scarborough CT Port St Lucie FI 34987
Legal Description, PODS 12 AND 13 PUD 1 AT THE RESERVE SCARBOROUGH ESTATES(PB 45-13)LOT 1(OR 3672-1487)
Property Tax ID#: 3322-507-0006-000-6 Lot No.1
Site Plan Name: Payne Block No.
Project Name: Payne
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of(18)Miami Dade Approved Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work to be ertormed under this permit——check a appy:
HVAC Gas Tank ❑Gas Piping V Shutters ❑Windows/Doors
0 Electric 0 Plumbing Sprinklers E]Generator F]Roof
Total Sq. Ft of Construction: Sq. of First Floor:
Cost of Construction:$ 2.000.00 Utilities: Sewer Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
N a me Thomas M Payne Name: SamuelZaza
Address:9424 Scarborough CT Company: Just Shutter It Inc
City: Port St Lucie State:_ Address: 1608 SW Taurus Ln
Zip Code: 34987 Fax: City: Port St Lucie State:FL
Phone N0.772-201-9919 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-201-9919
Fill in fee simple Title Holder on next page(if different E-Mail: justshutterit@gmail.com
from the owner listed above) State or County License: `Ql
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 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 a first inspection. If you intend to obtain financing, consult with lender or an attorney before
commoticing wor or recording our Notice of Commencement.
AN,A A /'\ - I
ygfiaturI6 of Owner/Agent/Less Sign ure o ontra or/License Hol e
STATE OF FLORIDA TATE OF FLOR A
COUNTY OF 3-S • ti-Q e COUNTY OF
The forgoing instrument was acknowledge before me The forgoing instrument Was acknowledged before me
this 1 day of a Q�� 20 1by this f day of 20__% by
�Av'LJo .-Pi1 2-
(Name
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu ic-State of Florida) _ (Signature of Notary P lic-State of Florida),� '
Personally Known OR Prwdu^ce' ffiM510m:�6m'
Personally Known OR rodrlCed I� ft'i tic # rpt F�n��da
Type of Identification.�iodu?e �- State �� Type of Identification:-P-ro'd(Ged, V ub�to
lies 61 �,'• ;,, *�;,,; try 6omm.ExPn#EE g56! Assn.
F� Q'' N m ExP g5E i
Commission No.� okalj Commission No. F.�
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Bonded ;_ ° °`,;,,•� _.rd
Revised 07/15/204
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED.
DATE
COMPLETED