HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'P �• Permit-Number: ��
RECEIVED
Building Permit Application
Planning and Development Services APR,2 6 2016
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 Accordion shutters
'PROPOSEDINP.ROVEMENT LOCATION:
Address) 5 Rio Verde Way Port- qt-- - Tair,J L--
Legal
Legal Delscription:St.. Lucie Gardens 26 36 40- That part of Blks 1 & 2 lyg.
ELY of US One
Property Tax ID#:3426-500-1249-000/6 Lot No.
Site Plan Name: Spanish Lakes Block No.
Project Name:
Setbac Is Front Back: Right Side: Left Side:
DET�4ILED DESGR.IPTION QF 1NORK: Instahl accordion shutters ;to (8;) ;openings:"
Seven windows and one sliding glass door.
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CO NSTRU CTI O N.:-W FO R MATT O N
Additionalwork to be nerformed under this permit-check all that appy:
.CIIHUAC Gas Tank Gas Piping �_Shutters ❑Windows/Doors
Electric ❑_Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: S
. Ft.of First Floor:
Cost of Construction:$ 3 200.00 UtilitiestSewerUSe
tic Building Height:
Name - a-m ,Teff Jackman
Address: 5 Rio verde Way Company: Master Craft Aluminum Prod,
City.: lPort St. Lucie State:FL Address: 1634 Se Niemeyer Cir.
Zip Code: Fax: City: . Port St. Lucie StatFFL
.
Phone No359-2782 Zip Code: 34952 Fax. 335-0860
E-Mail:1 Phone No. 335-1177
Fill in fie simple Title Holder on next page(if different E-Mail: mas r raf al umi n um(agma i 1 cc)m
from t ie Owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CO:NSTJ lJCT10N LIEN ,LA1N INFORMATION,
ir
.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: I 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 certifyI 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 i_"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,
accesso 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
commencin vyork or recording our Notice of Commencement.
MAi I
Signa re o er/Agent/Lessee Signa r tractor/License Holder
STAT L IDA STA F RIDA
COUNTYOF St. Lucie COON F St. LLcie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 181 day of Apr i 1 20a by thisl8 day of Apr i 1 20EOby
Jeff Jackman •TPff Jac-kman
.(Name of person acknowledging) (Name of person acknowledging.)
(Si_gnat ire-of Notary Public-State of Florida,) _ _(Signature.of Notary. blit-State.ofFlorida)
ersonally'Kno.wn X OR Produced Identification Personally Known x O.R Produced Identification
- -= -: .ype_oBdeatifi.cation_P-rodur -- --- - --- 3yA_
pe-oCldentifcatioRroduced-- --` - -- - __--- --- -- _--
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NOTARY
Commission No_ ;&a�OF FLORIDA Commission'No. NCj DI
Caw*FF942302 PUBLIC
020 STATE OF FLORIDA
Revised 07./15/2014 Expires 1/15/2020
REVIEWS FRONT ZONING SUPERVISOR ; PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW :REVIEW REVIEW
DATE .
:RECEIVED
DATE
COMPLETED
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