HomeMy WebLinkAboutBuilding Permit Applicaiton i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a
Date: �P -���L� Permit Number:
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' RECEIVED
- -- ---�- - Building Permit Application JUN 2 7
Planning and Development Services 2U19
Building and Code Regulation Division
Permitting De:pai•tmor,E �
2300 Virginia Avenue,Fort Pierce FL 34982 St.Luca County
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR:. Aluminum without concrete
PROPOSED IMPROVEMENT LOCATION: ;
Address: 9052 Short Chip Cir Port St Lucie, FL 34986
Legal Description: LAKES AT PGA VILLAGE BLK D LOT 55
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Property Tax ID#: 3334-501-0193-000-2 Lot No.55
Site Plan Name: Rudolf Block No. D
Project Name: Rudolf 1 '
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: -
Install a 20'x 10' aluminum/screen enclosure under covered roof(in fill only).
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CONSTRUCTION INFORMATION:
Additional work to be nertormed 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: S . Ft.of First Floor:
Costof Construction:$ 1,940.00 Utilities: Sewer[]Septic Building Height:
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O W N ERAESSEE: CONTRACTOR':
Name Kristi and Donald Rudolf Name: Michael J Newman
Address:9052 Short Chip Cir Company: Pioneer Screen Co. Inc. II
City: Port St Lucie State:FL Address: 1682 SW Biltmore St
Zip Code: 34986 Fax: City: Port St Lucie State:FL
Phone No.772-486-8942 Zip Code: 34984 Fax: 772-340-4626
E-Mail: Phone No. 772-340-4393
Fill in fee simple Title Holder on next page(if different E-Mail: pioneerscreen@msn.com
from the Owner listed above) State or County License: RX11066919
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LiEN LAVIJ INFORMATION
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DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _° Not Applicable
Name: es Name:
Address:mss- Address:
City: 4-+-- State: City: State:
Zip: Phone4-sw-@9-,e Zip: Phone:
44
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Aot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFiDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 aur property.A Notice of Commencement must be recorded and posted on the jobsite
before the first' pection. If ypV intend to obtain financing,consultwit rider or an a rney before
commencing k or recordi our Notice of Commencement.
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Signature o Owner/Less l ntractor as Agent for Owner Signature f Contractor) ice n s&Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Saint Lucie COUNTY OF saint Lu j-
The fo}r�oing instrumimt was acknowledged before me The forgoing instrurpea was acknowledg1d,,pefore me
this � n day of t/Ll ,20 by this i'X day of Gt,d'Lt ,20� by
Michael J Newman Michael J Newman
Name of person making statement Name of person making statement
Personally Known ✓ OR Produced Identification Personally Known ✓' OR Produced.identification
Type of identificatio Type of identification
Prod ced Produced
(Signature Notary Public-Stat ure of otary Public-S
y�o Notary Public State of F hda ,err at, Notary Public State of Florida
Commission No. GG221434 ' r Commi Newman �m ' sion No. GG221434 ' 0; ��4ne Newman
yCommission GG 22 4 My Commission GG 221434
f)alL
Expires 05/23/2022 7}OF Explros 05123/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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