HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �y
Date: Permit Number: I q IZ�
RF
- --- Building Permit Application ' No
Planning and Development Services 66pgp 1o/y
Building and Code Regulation Division NP Po'OIN
2300 Virginia Avenue, Fort Pierce FL 34982 °*iy 4-
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:.structural
PROPOSED IMPROVEMENT LOCATION:
Address: 3915 Dune Side Dr �/�/_ �/ nn� �}
Property Tax ID #: I �'Ytf'^w . -/ Lot No. 23
Site Plan Name: Block No.
Project Name: Lynch
,IPTION OF WORK:
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CONSTRUCTION INFORMATION r. 4
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 Constructio-h: $ 1970
.
I
_ Generator _ Roof
Sq. Ft. of First Floor:
Utilities: Sevyer-_Septic„-- Building Height:
Pitch
OWNER/LESSEE:;.
CONTRACTOR
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Name MicFaelSonsini, ,
actress: �✓ fi
Company: R & S Assembly D/B/A Screen Builders
ity: �i Pit Stater
ip Code: Fax:
hone o.65�;l - -
Address:8451 McAllister Way
City: West Palm Beach State: Fl
Zip Code: 33411 Fax: 561-793-5804
Phone No 561-793-6029
VE-Mail:Wr
ll e W4,9-1
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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
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,
SUPPLEMENTAL CONSTRUCTION-,LIEN`LAW INFORMATION- ,
DESIGNER/ENGINEER: _ Not Applicable
Name: FBC Plans & Engineering Services, Inc
MORTGAGE COMPANY: _ Not Applicable
Name:
Add reSS: 6272 Abboff station or # 101
Address:
City: Zephyrhills State: FL
Zip: 33542 Phone 813-788-5314
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 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 If Owner/ Lessee Contractor as Agent for Owner
Sig ature of Contractor/License Holder
STATE OF FLORIDA
Aim0azA
STATE OF FLORIDA,�
COUNTY OF
COUNTY OF /h 1/QaCh
The for sing instryrnent was acknowledgedbefore me
this X day of C406Pm i , 20 by
The f rgo�'ng instru nt was a knowledged before me
this �iS day of 4 ri 20by
�l►�haPl
rn�cd�tel SU�5Iri1
,S�nS�e��
Name of person making statement.
Name of person making statement.
�
Personally Known ,c OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
VIVIAN 0. E
entification
Produced o;;w.....,,
„ Notary Public -State
/ °• Commission H GG
"""""� VIVIAN 0. EKE
3076913 ?c " Notary Public -State of F
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My Commission
nnra` March 04, 2
s 9, Commission a GG 30
23 � �� My Commission Expi
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March 04 2023
(Signature of Notary Public -State o lorida
(Signature of Notary Public-S e o - o
Commission No. � (Seal)
3( 90
Commission No!6 (Seal)
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Hev. 2///19