HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t
Date: 1a+ -\1 %-� Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Applicati n DEC 0 9 c019
Commercial Residential X
FERMITTYPE: Aluminum with concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 5212 Pinetree Dr Fort Pierce, FL 34982
Property Tax ID #: 3402-602-0178-000-9
Site Plan Name: Rosko
Project Name: Rosko
DETAILED DESCRIPTION OF WORK:+
Form and pour�3e' pylon cube and Install a 36' x 12'
2
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: $ 7,130.00 Utilities: _ Sewer _ Septic
Lot No. 15 & 16
Block No. 5
Windows/Doors
_ Roof Pitch
Building Height:
' OWNER/LESSEEi .` c
CONTRACTOR.
Name David and Cristina Rosko
Name: Michael J Newman
Address: 5212 Pinetree Dr
Company: Pioneer Screen Co. Inc. II
City:. Fort Pierce State: I L
Zip Code: 34982 Fax:
Phone No. 631-3595
Address: 1682 SW Biltmore St
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-340-4626
Phone No 772-3404393
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail pioneerscreen@msn.com
State or County License RX11066919,
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
s
DESIGNER/ENGINEER: _
Name: Do xtm a Assodates
Not Applicable
MORTGAGE COMPANY: _
Name:
Not Applicable
Address: PO Box 10039
Address:
City: Tampa
Zip: 33679 Phone813-65%-9955
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
Not Applicable
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 thatis 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 nspection. If yog4ntend to obtain financing, consult with lender.or an attgrney before
commencinaidorK or recorclinzybur Notice or Commencement.
Signatu a of Owner/ essee/ ntractor as Agent for Owner
Signat�ontractor/U ens Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Saint Luae
COUNTY OF Saint Lucia
The for oing instr ppt was acknowledged before me
this day 17 V
The for oing instr ent was acknowledged before me
this �p day Puy by
of 26 by
of r 20�
Michael JNewman
Michael J Newman
Name of person making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identific 'on
Type of Identification
Produced
Produced
(Signature f Notary Public -State of FI rid
otaryPublic-Sta So F
Commission NO. GG221434 JM O� (��gqt(aa�K Public State of Florida
fi'faR�ene Newman
latureof
ut+ep No}1a__ry Public State of Florida
mission No. cczz143a °1t� Fr�Ael{): Newman
My Commission GG 221434
. My Commission GG 221434
y''roi
y�niM1oE' Expires 05/23I2022
Expires 05123/2022
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Rev.8/2/17