HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� °� �� Permit Number: \(1 a'U3
- RECEI!'�D DEC 19 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: Shutter
PROPQSED IMPROVEMENT LOCATION
Address: 19 Vera Cruz, Ft Pierce FI 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 19 vera cruz(0.17 AC-7,405 SF)(OR 3708-2289)
Property Tax ID#: _�nn _nn� A'Wl_ cmaI_ GGo- 5 Lot No. 19
Site Plan Name: 19 Vera Cruz Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESOF W
CRIPTION ORK s �'
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CONSTRUCTION INFORMATION fi
Additional work to e oirtormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 3,10 0 .0 0 Utilities:cn Sewer 0Septic Building Height:
OWNER%LESSEE CONTRACTOR
Name Normand&Phyllis Fortier Name: Jeff Jackman
Address: 19 Vera Cruz _ Company: Master Craft Aluminum Products
City: Ft Pierce State:_ Address: 1634 SE Niemeyer Cir
Zip Code: 34951 Fax: _ City: Port St Lucie State:fl I
Phone No.603-540-0305 Zip Code: 34952 _ Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page (if different E-Mail: mastercraftaluminum@gmailcom
from the Owner listed above) State or County License: SCC131150586 i
!f value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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 orlZcording your Notice of Commencement.
W K—
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SiKat~Ok er Les a/Contractor as Agent for Owner Sap
cense Holder
ATE O RIDA S
CO O F St Lucie C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this It day of 20/ by this 11 day of L-, 20 L by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of NotaryPublic-State of Florida) (Signature of Notary Public-State of Florida) —
Personally Known ✓ OR Prod enliBnMooro Personally Known b/" OR Produced Identification -
Type of Identification Produced NOTARYPUBUC Type of Identification Produced_ _
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S7ATE OF FLORI NO qRY P138t1C
Commission No. , `':,f llJomm#FF942382 Commission No. _ �� TE OFFLOMDA i
Expires 1/15/2020 Com FF942W
— ANAP1020
Revised 07/15/2014 -Ji
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION + SEA TURTLE MANGROVE I�
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIE\k I
DATE — -- --�-- --------- -' ti
COMPLETE (
INITIALS ---- -�- �--------;�4
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