HomeMy WebLinkAboutO'Shea ApplicatinAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
CD
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
PERMIT APPLICATION FOR: 2021 NW Laurel Oak Lane
Address: 2021 NW Laurel Oak Lane
Property Tax I D #: 4425-605-0049-000-9 Lot No.
Site Plan Name: O'Shea Residence Block No.
Project Name: Timothy & Rita O'Shea
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Installtion of Concrete Slab and Installation of Screen Enclosure
New Electrical Meter Second Electrical Meter
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Additional work to be performed under this permit– check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 5625.00 Utilities: —Sewer —Septic Building Height:
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NameTimothy O'Shea
Name:Craig Rice
Address: 2021 NW Laurel Oak Lane
Company: Pioneer Screen LLC
City: Palm City State: _
Address: 3290 SE Slater Street
City: Stuart State: FL
Zip Code: 34990 Fax:
Phone No. 860-299-6754
Zip Code: 34997 Fax: 772-283-3028
E -Mail:
Phone N0772-283-9197
E -Mail Bev@pioneerscreen.com
Fill in fee simple Title Holder on next page ( if different
State or County LicenseSCC046064
from the Owner listed above)
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.
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip:
Phone
Zip: Phone:
FEE SIMPLE
TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or ref-ording vaur Notice of Commencement.
M
er
as Agent for Owner /signature of(Cobtractor,
STATE OF PILORIDA STATE OF FLORIDA
COUNTY OF{ COUNTY OF ( (1
Swornor affirmed) and subscribed before me of
Pal Presenc or Online Notarization
this ay of 2020 by
Name of peUn making statement.
Personally Known "' OR Produced Identification
Type of Identification
Produced
otary
Commission No.
S','WN JAMBS- l
Commission # GG 094114
My Comm. Exoiro Aar 13, 2021
REVIEWS I FRONT I ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Sworn_t$(or affirmed) and subscribed before me of
L -'Ph sical Presenceor Online Notarization
this ]qday of 2020 by
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Name of pe n making statement.
Personally Known L,-"�OR Produced Identification
Type of Identification
Pro ced
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(Signature of Notary P lic- State of Florida )
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Commission No.
. „, Notar��u�1i� StateuiFlorida
Commission d GG 094114
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