HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G
Date: �,r, Permit Number:
RECEI`.'rD MAY 0 6 7035
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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 Commercial Residential xx
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 9621 Short Chip Cir Port St Lucie FI 34987
Legal Description: LAKES AT PGA VILLAGE(PB 43-32)BLK D LOT 1(OR 2212-2944;3440-2843
9621 Short Chip Cir Port St Lucie FI 34987
Property Tax ID#: 3334-501-0139-000-6 Lot No.1
Site Plan Name: Hayes Block No. D
Project Name: Hayes
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of(01 WHITE Miami Dade Approved Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all tbat appy:
HVAC Gas Tank 0Gas Piping WShutters a Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers 1:1Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ a.soo.ao Utilities: Sewer Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name Gerald"ayes Name: Samuel Zaza
Address:9621 Short Chip Cir Company: dust Shutter It Inc
City; Port St Lucie State:FL Address: 1608 SW Taurus Ln
Zip Code: 34987 Fax: City: Port St Lucie State:FL
Phone No.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: C
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: =Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: =Not Applicable BONDING COMPANY: =Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply..
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commemcing work or recording our Notice of Commencement.
'Signature of Owner/Agent/Lessee ature of Contractor/License FVder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 6k'. COUNTY OF S k. L v C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this CP day of TN 20 1S by this Co day of V1\ 20_AS by
S a. Y'$r��?�.� 'Z qZ � • S�w.y e.\ Zd1 L o�
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida '" (Signature of Notary P blit-State of Florida)
S
Personal) Known O i d dNi1� X g`t o�6 Personal) Known OR Produced eth :P RNs �a
Y Y
Type of Identification Pro!Vied t--Deo��' Type of Identification P�rodu . t e� o�# N° 4 �c' N°1a y ` xP�t EE a5816 sn•
Commission No. G:: �8y�omcn{s� pC�ona� Commission No. �`6$' S My cq�S���,on# NO�acy Fs
Revised 07/15/20,� � G7} r
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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