HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2 Permit Number:
• , RECEIVED JUN 2 2 2916
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: 9206 Champions WAY Port St Lucie FI 34987
Legal Description: LAKES AT PGA VILLAGE(PB 43-32)BLK B LOT 17(OR 3353-2377)
Property Tax ID#: 3334-501-0095-000-5 Lot No.17
Site Plan Name: Tom Block No. B
Project Name: Tom
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of(9)Miami Dade Approved Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all appy:
HVAC Gas Tank E]Gas Piping �_Shutters ❑Windows/Doors
11 Electric Plumbing Sprinklers E Generator 17-1 Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 7,500.00 Utilities:[]Sewer ElSeptic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name Thomas A Romanko Name: SamuelZaza
Address:9206 Champions Way Company: Just 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@gmaii.com
from the Owner listed above) State or County License: 24293
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
commencinR work Qr recording our Notice of Commencement.
J /I J" 4,�� //,-, , J *
Signat, a Owner/ -gent/Lesse Signa re f Contracto /License Holder/
TE OF FLORIDA ATE OF FLORIDA
COUNTY OF 153r , Ly c \`Z COUNTY OF G--�.
The forgoing instrument was acknowledged fore me The forgoing instrument was acknowledged oefore me
thisa� day of 20 by this3�day of -o.A 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu ic-State of Florida) (Signat�Nota -Stateof Florida) P�tvE''N tocida `,
pEPN of F
Personally Known OR Pro g{#i�> r�� cida Personally Known!of R>r.` 4ed�et�t gt iD tate l6 2��6
Type of IdentificatieP� ua� �rl_ � State° Type of Identification Proc�ucetJaY P }d— ai Expi61 od.=My Riissi� alNotall
lad
Commission No. MY�0c��)oe# N,tasy Ps$P y, Commission No. °r 11�E�`ldi�U9 �aszrJ"s
\. r: "pf�°EO
Revised 07/15/2014",;,'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED