HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /, �7 �r1 (�,
Date: Ii'�r%' Permit Number. l "II !i o6c,5
DEC 272019
Building Permit ApplicationParmittn9D
Planning and Development Services St. Lucle Countmyent
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
PROPOSED•IMPROVEMENT LOCATION
Address: 3929 Shore Side Drive
Property Tax ID #: 1423-566-0006-000-3 Lot No._
Site Plan Name: Block No.
Project Name: Tarpon Flat 3
CONSTRUCTION INFORMATION.''+' '. :-
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_Electric _Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 2664 Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height:
OWNER/LESSEE;' ". ""-•
:CONTRACTOR..➢
NamgJ
Name: Michael Sonsini
Addre s: 067 Maloft
IM
Company: R & S Assembly D/B/A Screen Builders Inc
City a State: _
Zip Codes Fax:
Phone ) -7619'
Address:8451 McAllister Way
City: West Palm Beach State: FI
Zip Code:33411 Fax:561-793-5804
Phone No 954-804-1198
E-n ' • P.{MI-M_,
0WVO;
H W50C.l r tM
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 constriction 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.
mi
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.:*
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: FBG Plans & Engineering Services. Inc. Name:
Add resS: 6272 Abbott station Dr. n 101 Address:
City: Zephyrhills State: FI City: State:
Zip: 33542 Phone 813-788-5314 Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 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."
i
dli
Sign ure of Owner/ Lessee/Contractor as Agent for Owner
Sign te of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm Beach
COUNTY OF Palm Beach
The f�r�yIng instrument was acknowledge before me
y
The foing instrument was acknowledged before me
rpp
/ December
this day of December 20IL by
this. day of 20A 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 Identificaton
Type of Identification
TvoeofIdentification VIVIAN O. EKEY
""`¢''-
Produced
VIVIAN O. EK
Notary Public -State of
d �".' ary Public -State of Flo
Florida '• 'S Commission rt GG 3078
7- ��nf„7n°�eMy Commission Expire
Commission q GG
Ex
March 04, 2073
., ,..�� My Commission
it /K
(Signature of Notary Public-
JalpWure of Notary Public- a of Florida )
Commission No. GG307898 (Seal)
Commission No. GG307898 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
1
DATE
COMPLETED
ev.