HomeMy WebLinkAboutcorrected building permit applicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
Permit Number:
L N� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address: 1409 NW Winters Creek Road
Property Tax ID #: 4425-825-0009-000-6
Site Plan Name: Charles White
Project Name: White Residence
Removal of Existing Pool Screen Enclosure and Installation of Pool Screen Enclosure
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit– check all that apply:
Lot No. 8
Block No.
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors — Pond
_ 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 City 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 Screen LLC
Address: 3290 SE Slater Street
City: Stuart State: FL
Zip Code: 34997 Fax: 772-283-3028
Phone N0772-283-9197
E -Mail Bev@pioneerscreen.com
State or County LicenseSCC046064
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: , Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip: —
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
Pq`STED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WffH YOUR LERPFR OR AN ATTORNEY BEFORE RECORDIN® YOUR NDTICF DF- COMMENCEMENT_"
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Signature of O nee�r/ Lessee/Contractor as Agent for Owner
Signature of ntractor/License Holder
STATE OF FL
STATE
OR
COUNTY OF E(yL ' 1t.4
COUNTOY OF Cz��
The forgoing instrument was acknowledged before me
t1his / day of iiEllu* 20 by
The forgoing instru. nt was acknowledged before me
�'
this(i day of_ 2 by
Name of 06son making statement.
Name of pekbn making statement.
Personally Known �'_ OR Produced Identification
Personally Known "—f OR Produced Identification
Type of Identification
Type of Identification
Pr duced
Produced
(Signature of Notary Public- State of Florida
(Signature of Notary Public- State of Florida i
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Commission N om `- ` �N
Commission No. r WMA
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! EXFIREE& JGiy 6,24 0PJ
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EXPIRES: J., a ;, 202
IhruNoaryPub!i,Und=r::;dz,s
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REVIEWS
FRONT
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SUPERVISOR
PLANS
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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