HomeMy WebLinkAboutWhie ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
.
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
PERMITTYPE:
Address: 1409 NW Winters Creek Road
Property Tax ID #: 4425-825-0009-000-6 Lot No.8
Site Plan Name: Charles White Block No.
Project Name: White Residence
Installation of Pool Screen Enclosure
Additional work to be performed under this permit –check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 6711.00
Sq. Ft. of First Floor:
Utilities: -Sewer _Septic Building Height:
Name Charles White
Address: 1409 NW Winters Creek Road
City: Palm Clty State: _
Zip Code: 34990 Fax:
Phone No. 919-348-1426
E -Mail: ctwhite007@aol.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Craig Rice
Company: Pioneer Screeen LLC
Address: 3290 SE Slater Street
City: Stuart State: FL
Zip Code: 34997 Fax: 772283-3028
Phone N0772-283-9197
E -Mail Bev@pioneerscreen.com
State or County LicenseSCC046064
it value or construction is :�csuu or more, a KLLUKDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
Name:_
Address:
City:
Zip:
Phone
_ Not Applicable( MORTGAGE COMPANY: _ Not Applicable
Name:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
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 YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
P�TED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
W H YOUR LE OR AN ATTORNEY BEFORE RECORDI YOUR NOTICE OF, COMMENCEMENT."
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Signature of O ner/ Lessee/Contractor as Agent for Owner
Signature of ntractor/License Holder
STATE OF FLDtLUI_6
STATE OF FLOR A
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COUNTY OF
COUNTY OF 1C
The for ing instrument was acknowledged before me
this/day of i71�C�a `
2by
The forgoing instru , nt was acknowledged before me
this day ofLc 2-`t\ by
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Name of a son making statement.
Name of pekn making statement.
Personally Known OR Produced Identification
Personally Known --- OR Produced Identification
Type of Identification
Type of Identification
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Produced
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(Signature of Notary Public State of Florida
(Signature of Notary Public- State of FloridaHAC )
Commission No.
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DATE
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DATE
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