HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 1 (T Permit Number: I T2 — 4
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
PERMITTYPE: Structural
,PROPOSEDIMPROUEfVIENTLOCATION `_
Address: 3906 Dune Side Dr
Property Tax ID #: 1423-566-0035-000-5
Site Plan Name: TARPON FLATS SUBDIVISION (PB 69-27) LOT 32
Project Name: Alberg
DETAILED DESCRIPTION OF WORK:, �a
patio
CONSTRUCTION INFORMATION: , ,
Lot No. 32
Block No.
Additional work to be performed under this permit —check all that apply. -
Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction:GD
Generator Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
.OWNER/LESSEE;',
Cb.NTRACTR
NaR'Rs r S
Name: Michael Sonsini
AddreSr f it 5
Company: R & S Assembly D/B/A Screen Builders Inc
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City: eI JV J State:MV
Zip Coded ) I V r6 Fax:
Phone No -ay -7cP- 59oo
Address:8451 McAllister Way
City: West Palm Beach State: FI
Zip Code: 33411 Fax: 561-793-5804
Phone No954-804-1198
E-Mail:_��
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Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail Permits@screenbuildersinc.com
State or County License RX0066796
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if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
ISUPPL•`EMENTALCONSTRUCT(ON,LIEN.LAW INFORMATION = <,
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Meridian Land surveyors Name:_
Address: 1717 Indian River Blvd # 201 Address:
City: Vero Beach State: FI City:
Zip: 32960 Phone 772-794-1213 Zip:
FEE SIMPLE TITLE HOLDER: _ Not Applicable I BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Address:
Zip:
_Not Applicable
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or an9covenants 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature f Owner/ Lessee/ ontractor as Agent for Owner
Signat re of Contractor/License Holder
STATE FLORIDA
STATE OF FLORIDA
COUNTY OF Palm Beach
COUNTY OF Palm Beach
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 12 day of December 20_ by
this 12 day of December 20_ by
Michael Sonsini
Michael Sonsini
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification,
Personally Known x OR Produced Identification
Type of Identification
Prod ced 8;•6 VIVIAN
Ication
„i,,g�,, VIVIAN 0
4Notary Public-
= •F Commission
t� ce �. Notary Public -St
I GG307698eujo ='
P Commission #
My Commis
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1
March 0
, 2023 March 04
(Signature of Notary Public-S a of Florida)
(Signature of Notary Public-S a of o i
Commission No. GG307698 (Seal)
Commission No. GG307698 (Seal)
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