HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLq INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 19
r} Permit Number: ' C(151
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: 9306 Wentworth Ln Port St Lucie A 34986
Legal Description: POD 20A AT THE RESERVE PUD II CATLE PINES LOT 68
Property Tax ID#: 3327-801-0076-000-5 Lot No.68
Site Plan Name: Jim Block No.
Project Name: Jim
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Installation of(10)Miami Dade Approved Accordion Shutters
CONSTRUCTION INFORMATION:
Additional work to begertormed under this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping �_Shutters ❑Windows/Doors
Electric El Plumbing Sprinklers E]Generator El Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4,600.00 Utilities:I Sewer Septic Building Height: 15'
OWNER/LESSEE: CONTRACTOR:
Name Jim Cink 'r Name: Samuel Zaza
Address:9306 Wentworth Ln Company: Just Shutter It Inc
C9 : Port St Lucie State:FL Address: 1608 SW Taunus Ln
Zip Code: 34986 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 simpie Title-Holder on next page(if different E-Mail: iustshutterit@gmail.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 Counter 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.
Sign to of caner/Agent/L s Sig to of Contractor/License old
ATE OF FLORIDA / TATE OF FLORIDA `
COUNTY OF G\ COUNTY OF A G
The f oing instru nt was acknowledgedbefore me The f oing instrum nt was acknowledged fore me
this day of 20 . by this day of U 20 by
(Name of person acknowledging) (Name of person acknowledging)
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Bonded through National y 2 j 2!)19
Commiss.i n )Assn. ° Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED