HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE I FOM ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
M MT
- Building Permit Application
Planning and Development Services
Building and Code Regulation Division
23000 Virginia Avenue,Fort Pierce FL 34982 /
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential ✓
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: 17 La Villa Way, Fort Pierce, FL 34951
Legal Description:�_Spanish Lakes Country Club village leasehold Estates(or 2389-639)that part of sec as shown in or
2389-639 being lot 17 La Villa Way(0.19 AC-8,276 SF)(or 3848-1494)
Property Tax ID#: 1301-5000622-000-8 Lot No. 17
Site Plan Name: Block.No.
Project Name: Rosenzweig
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
N�i4�� aN
C_CC) to 1-) 5LIVEE e-
CONSTRUCTION INFORMATION:
Additional work to be nertormed under t ispermit—check all appy:
QHVAC Gas Tank ❑Gas Piping Shutters a Windows/Doors
Electric 0 Plumbing O Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1 Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ellen R Rosenzweig Name: Edward J Heritage
Address:17 La Villa Way Company: Folding Shutter Corp
City: Fort Pierce State:FL Adcl-e' " 7080`Hemstreet.Place
Zip Code: 34951 Fax: City: .West,,Palm,E9each�., State:FL
-Phone No.-,772=626-9374., :` ' Zip Code. Fax:Fax: 561-640-8204_
E-Mail: Phone No.` 61'-683-4811
Fill in fee simple Title Holder on next page(if different E-Mail: Info@foldingshutters.com
from the Owner listed above) State or County License: SCC131151041
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLE„ MEN�TfAL CONSTRUCTION LIEN LAW INFORMATION:
awk
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
commencing work or recording our Notice of Commencement.
:. 5
Signature of Owner/Le a Contrac as Agent for Owner Signature of Co—n,— r/Lice older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palmi3each COUNTY OF Palm seach
The forging instrument was acknowledge before,me The forgoing instrument was acknowledged before me
this 3 day of -5'P J— 20 by this 3a day of 20« by.
Edward J HeritagellL Edward J Heritage
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. [- 1' )S (Seal) Commission No.t�Y i C'7 (Seal)
��tA1ty ass PAMELA A.EVANS
S STATE OF FLORIDA °o NOTARY PUBLIC
Revised 07/15/2014 Comm#FF150967 W STATE OF FLORIDA
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION-INCSEA TU LT ITi/ib9ROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
,J.-COMPLETE
INITIALS