HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: August 6th 2016 Permit Number:
== RECEI'.' .0 110V 17 2016
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 X
PERMIT APPLICATION FOR: Shutters -I
PROPOSED IMPROVEMENT LOCATION:
Address. 905 Easy Street, Fort Pierce, FL 34982
Legal Description: Indian River Estates Unit 06-BLK 13 Lot 37&38 (Map 34/11 S)(or 3465-2765: 3559-632: 3564-859)
Property Tax ID#: 3402-607-0086-000-2 Lot No.37
Site Plan Name: Block No. 13
Project Name: Coan
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Furnish and install 1 Accordion Hurricane Shutter# C>j4cNck.," Oi
c
CONSTRUCTION INFORMATION:
Adclitional work toe e Orme under this permit—check a appy:
HVAC 11 Gas Tank ❑Gas Piping ✓_Shutters Q Windows/Doors
Electric F] Plumbing OSprinklers E]Generator Lam.Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 4625.00 Utilities:ll Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Martha Coan Name: John Rosendale
Address:905 Easy St Company: National Shutter&Aluminum
City: Fort Pierce State:FL Address: 700 Commerce Way W
Zip Code: 34982 Fax: City: Jupiter State:FL
Phone N0.772 807-2727 Zip Code: 33458 Fax: 561 748-8902
E-Mail: Phone No. 561 748-8806
Fill in fee simple Title Holder on next page(if different E-Mail: becky@nsacompanies.com
from the Owner listed above) State or County License: CBC1253858
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 thepermit 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 att ey befo
commencing work or recording our Notice of Commencemen
S
Signature of Owner/Lessee/Contractor as Agent for Owner Signat o o ra older
i -
STATE OF FLORIDA,,"' NTY SAT F FLORIDA
COUNTY OFOF
The fpr Instru nt was acknowledged before me The for g instru a was acknowledge before me
this 7"/ day of..; OVX 20��by this ay of !/A" 20/ by
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(Name of perso acknowl Ing) (Name of pe acknowledging)
(Signature of Notary Public-StateIced
Florida) (Signalu a of
Notary,ublic-State of Florida)
Personally Known C Pro Identification Personally Known OR Produced Identification
Type of Identifica " n Produced Type of Identificat' nlfi Produced
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Commission No. °s: yam:
MY COMMISSION#FF069676
ft, rQ; MY COMMISSION#FF069oPp
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arch 5, 2078 (407)398-0153 FloridallotaryService.com
Revised 07/15/2014 (407)398-0153 Floridallotaryservice.com
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