HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I2"t' I� Permit Number: J
RECEIVED
Building Permit Application DEC 0 4 2018
Planning and Development Services
Building and Code Regulation Division ST, Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xxxxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line YW l-� III
Address: 15370 Skyking Drive
Legal Description: Treasure Coast Airpark Lot 67 (9.43 AC) (OR 3894-1818: 4001-2899)
Property Tax ID #: 4224-501-0067-000-5
Site Plan Name: Ciuperger Residence
Project Name:
Residence
Setbacks Front Back:
Side: Left
Installation of Pool Screen Enclosure on Existing Slab!
I�HVAC ❑Gas Tank ❑Gas Piping
❑Electric ❑Plumbing ❑Sprinklers
Lot No.
Block No.
Shutters ❑ Windows/Doors
Generator ❑ Roof ❑
Total Sq. Ft of Construction: r�' S Ft. of First Floor:
Cost of Construction:$ , 7 -60 Utilities:cnSewer❑Septic
Building Height:
Roof pitch
OWNER/LESSEE r'.,k z x rF
ONTR
C/�C7OR
:�i
NamBKristina Ciuperger ,
Name: Craig Rice
Add ress: 15370 Skyking Drive
Company: foneer Screen LLC
City: Port St. Lucie State:FL
Zip Code: 34987 Fax:
Phone No.
Address: 3290 SE Slater Street
City: Stuart - State: F!
Zip Code: 34997 Fax: 772-283-3028
Phone No. 772-283-9197
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Bev@pioneerscreen.com
State or County License: SCC046064
If value of construction is $2500 or more, a RECORDED Notice of Commencement is
�SUPPLEMEtVTAL
COIVSTEtUCTIOIVLIEN
LAVt1 INFORMATIQIV
p
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not ApPI'icable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address: 3290 SE sI.Wl Sl .t
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 Countyy 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
corryrftencing work or recording your Notice of Commencement.
l
ign fur o Owner/ Lessee/Contractor as Agent for Owner
Signature of ntracto /License Holder
STATE OF FLORIJ��4,�
STATE OF FLORIDg�
COUNTY OF /JJUi f
COUNTY OF
The fo riming instru nt was acknowledged before me
thisZA—dayof ��_ 20/R-by
The f gping instrur�t was acknowledged efore me
this ��sr`Iday of L.4t� C 20_ by
afie of person m king statement
Na of person making statement
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identificati n
Type of Identification
Produced
Produced
n
-
Signature of No
(Signature o ota
DDAD
`i'gJs,'o"g'.•t.,,, BEV L. HA DADMY
Commission No. '; : MY COMMIS")GG 009363
Commission No .4
�i- '�' COMMISS)QN# Z 20363
- EXPIRES: July 6,2020
,Bonded Thm Notary Public Undenttilers
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'%:"o, EtgP' Boded Thm Notary Public Undenmters
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLA
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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REVIEW
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DATE
RECEIVED
DATE
COMPLETED
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Rev.8/2/17