HomeMy WebLinkAboutPruitt - Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: C� 01,62'.0,Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commer ial Residential X
PERMITTYPE:Aluminum without concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 1808 Hazelwood Dr Fort Pierce, FL 34982
Property Tax ID #: 2433-502-0012-000-4 Lot No. 12
Site Plan Name: ESTATES OF LONGWOOD LOT 12 Block No.
Project Name: Pruitt
DETAILED DESCRIPTION OF WORK:
Install a 44'x 32' aluminum/screen pool enclosure on existing
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit –check all
_Mechanical _ Gas Tank _ Gas Piping
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 12,000.00
Sq
Utilities:
deck.
at apply:
_ Shutters
Generator
of First Floor:
Sewer _ Septic
Windows/Doors
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
Name Samuel Pruitt
Name:
Co
Ad
Cit
Zip
Ph
E -Mail
State
Michael J Newman
Address: 1808 Hazelwood Dr
ii pany: Pioneer Screen Co. Inc. II
City: Fort Pierce State: fi—_
Zip Code: 34982 Fax:
Phone No. 971-3534
ress: 1682 SW Biltmore St
: Port St Lucie State: FL
Code: 34984 Fax: 772-340-4626
ne No 772-340-4393
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
pioneerscreen@msn.com
or County License RX11066919
- — w• —Nall L moil 40U%J OF nwre, a rcEw1%UtU rvorice or 1-om encement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commence ent is required.
DESIGNER/ENGINEER:
N a me: Do Kim & Associates
Address: PO Box 10039
City: Tampa
_ Not Applicable
Mate: FL
Zip: 33679 Phone 813-857-9955
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:.
Not Applicable
, pd
®t
i
e .► s =,
a
Phone:
State:
,JNot Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made Lo obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuz nce of a permit.
St. Lucie County makes no representation that is granting a permit wil authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rule;, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and rev ew your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby gree 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 Commencem nt must be recorded and posted on the jobsite
before the first ins ction. If youi $end to obtain financing, consult with.lender or an �f�may before
commencing wop r recording y�r Notice of CommenceMent. 1.7 /
Signature ofibwner/
STATE OF FLORIDA
COUNTY OF saint Lucie
ctor as Agent for Owner
The forgoing instrument was acknowledged before me
this day of20,� by
Michael J Newman
Name of person making statement
Personally Known V' OR Produced Identification
Type of Identificat
(Signaturelbf Notary
c$Y F'Aa Notary Public State of Florida
Commission No. GG221434 Frik$tg4 Newman
M eQ My Commission GG 221434
�d"Or- Expires 05/23/202.2
Sig atur¢ of Contra ctgfF/Licens f Holder
ST TE OF FLORIDA
COUNTY OF SaintLu A.
Th fcr oing instrument was acknowledged before me
thi ,04 -day of QCk-D 20 DLO by
Mict aei J Newman
Name of person making statement
Per onally Known AOR Produced Identification
Tv e, of Id�n
entificat
of Notary Pub -e,of Fnda
Notary dublic State of Florida
Francene Pewman
1 No. GG221434 My C��je�31
on GG 221434
0Fno- Expires 05/23/2022
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