HomeMy WebLinkAboutBuilding Permit Application i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1l I fo � lam_ Permit Nu-"----_'.
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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 xxx
PERMIT APPLICATION FOR: Shutter
PROPOSED IMPROVEMENT LOCATION:
Address: Qy 01 nPoi e n �- LLVI�-t,,
Legal Description: t' I A{e s 0, -The '1'Q ctseryeS 07 12
C r' o ► 33 5 , ';�Q SS — 5�
Property Tax ID#: 33ZZ1- 5_ 02__ - 00121 - 00-G - 5 Lot No.�3
Site Plan Name: (31-) I LS Block No.
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Project Name:
Setbacks Front Back: Right Side: Left Side:
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DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (_( ) MIAMI DADE APPROVED ACCORDION,SHUTTERS
CONSTRUCTION INFORMATION:.
Additional work to be performed under this permit-check all that.appy:
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❑HVAC E—Gas Tank ❑Gas Piping Shutters ; ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generatorj ❑ Roof .Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer❑Septic Building Height: 15
OWNER/LESSEE: CONTRACTOR: I
Name P.Q_r)dQ I S Name: SAMULE ZAZA
Address: Qy O 1 Pie rtea LD Company: JUST!SHUTTER IT INC
City: Gwci- SA, State: FL Address: 1029 SW S. MACEDO,BV
Zip Code: Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 349841 Fax:
E-Mail: Phone No. 772-201-9919
Fill in fee simple Title Holder on next page(if different E-Mail: .JUSTSHUTTERIT@GMAIL.COM
from the Owner listed above) State or County License: 24294
If value of construction is$2500 or more,a RECORDED Notice of Commencement is 'required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: (I i
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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: i
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 wrk or record our Notice of Commencement.
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Sign re f Owne Lessee/ o ractor as Ag for Owner Sig t o nt ctor/Lice se older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OFtL
The forgoing inst ument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 laby this day o 20 ��] by
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(Name of person acknowledging) (Name of person acknowledgin ) 6 S
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CAX:Z
(Signature of Notary Public-State%f Florida) (Signature o Notary' Public-State of FI 'da)
Personally Known OR Produced Identification Personally Known - OR Produced Identification
Type of identification Produced Type of Identification Produced
Commission No. n ea'1) _:,� ommission No. quo
.,o����"„ LASHAHNA INGRAM
�lPRY Ppei
a _�, „` Notary Public-State of Florida
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Revised 07/15/2014 ` C� ° F'+';fFt1�7 ';" ops;= Commission#FF 177249
Eon.: ugnal 'I, Bonded through National Notary Assn i
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