HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: 1 l / 17 Permit Number: ' I,1
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: ! r
Address: %E 20 60,1 ty (3o_yn l 0 r\ RC(
Legal Description: POt) 32 -k-C -Ch2 QSelva OLLD it S�u�QSS L0+
(09- 3345--1
Property Tax ID#:3j3q - (�Ob — 080!o . - 000 -0 Lot No. G
Site Plan Name: "'nal.th P-e-a - j Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
INSTALLATION OF (IA) MIAMI DADE APPROVED ACCORDION SHUTTERS
,
CONSTRUCTION INFORMATION:
Additional work to be Dertormed under this permit-check all appy:
HVAC Gas Tank ❑Gas Piping Shutters i F�Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ (1 � C/G Utilities:�Sewer Septic Building Height: 15'
OWNERAESSEE: "CONTRACTOR: !'
Name Kew r Pe r pry Name: SAMULE ZAZA
Address: J-&S 20 ac;, 1U 6kf1 Lo%A Company: JUST SHUTTER IT INC
City: [)Oy-t - '(4- L- ka« State: FL Address: 1029 SW S. MACEDO BV,
Zip Code: 342 Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34984 Fax:
E-Mail: Phone No. 772-201-99%
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 j
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
i
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 w rk or ording your Notice of Commencement.
Si at of w er/Lessee/Co ctor as Agenty Agent-fOwner S ngtdfe of Contractor/License Hol e
STATE OF FLORIDASTATE OF FLORIDA
COUNTY OFCOUNTYOF
The f r oing instrent was acknowledged before me The foryng instr ent was acknowledged before me
tl% day of li 20'�by this p�day of 20 by
(Name of person acknowle ng) (Name of person acknowledging
Si nat a of Notary Public-Stabe of Florida) (Signature of Notary Public-Stat f Florida) V
Personally Known OR Produced Identification — Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No ' "RYX�-,,
Commission No. „�,�„ LASHAH ING qM
•t — LASHAHNA INGRAM '2` °' Notary public
Notary public- .';MV State of Florida
a pk -, oP: ec 0.2018.
Ex i 2018J '••;`oF.r�o;:••'' Commission#'FF 177249
a, Pres Dec 20, „����„
Revised 07/15/ 1 �,;; Commission#FF 177249 BondedthroughNationalNotarygssn. .
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DATE
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