HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dt
ul-
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Permit Number:
Building
Permit Application
Commercial
PROPOSED IMPROVEMENT LOCATION:
Residential XXXX
Address': $529 BELFRY PLACE
Property Tax I D #: 3327-701-0051-000-7 Lot No.
Site Plan Name: Block No.
Project Naas.
DETAILED DESCRIPTION OF WORK:
BUILDING SCREEN ROOM ONLY...SCREEN ROOF
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 2375.00
Gas Piping
Sprinklers
Shutters
Generator
Windows/Doors Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer � Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name -TOM SMITH
Address:8529 BELFRY PLACE
Name: MARIO RUSSO
Company.MARlO RUSSO ALUMINUM INC
City: PORT SAINT LUCIEState:
Zip Code: 34986 Fax:
Phone No,, 419-260-0065
E -Mail:
Address: 291 SW DUVAL AVE
City: PORT SAINT LUCIE State:- FL
Zip Code: 314983 Fax:
Phone N0772'370-8671
F'1111,in fee simple Title Holder on next page (if different
E -Mail mariorussoaluminum@gmail.com
from the Owner listed above)
State or County License30367
If value of construction is 2500 or more, a RECORDED Notice of Commencement Is required.
If galas of H Is$7,500 or more, a 'RE+ RDED Notice ofCommencement Is required.
0
r -
SUPPLEMENTAL CONSTRUCTION
LIEN LAW
INFORMATION:
DESIGNER/ENGINEER: _Not
Applicable
MORTGAGE COMPANY:
xX Not Applicable
N d fpe: Florida aluminum engineering
Ad d ress 5601 mane,stsuite„0
City: pampa
Zlps 33609 Phone 813374-2403
State: Fl
Named#N/A
Address:
City: �
Zip: Phone:
State.
FEE SIMPLE TITLE HOLDER*. xx
Name:
Address:
City:
Zip: Phone..
Not Applicable
BONDING COMPANY:
Name:
Address:
City:
� Not Applicable
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT,*, Application is hereby made to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Ducie 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, bylawsor and covenants that may, restrict or prohibit such
Structure. Please consult with your Name Uwners Association and review your deed for any astrictions which may apply.
Inconsideration 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
accessory structures, swimming pools, fences, walls, signs, screen rooms
full concurrency review: room additions,
and accessory uses to another non-residential use
WARNING TO OWNEF 90 Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your
Lucie County and post(
with lender or
property.
d on the j
A Notice of Commencement must be recoreed in the public records o
Af youA-..4
obsite before
or,ne4before commencfnr.
the first i
work or
nspection
recording
to obtain financing,
'Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE � rr"LORNIND&A
F
Sworn to (or affirmed) and subscribed before me
Physical Presence or
this day of _
11dillt u1 [AeFb ll 111dKI
Personally Known
Type of Identification
Produced
2020 by
R Produced Identi#ic
STATE OF FLORIDA
COUNTY of
sr LUCIE`
Sworn to (or affirmed) and subscribed before me of
woo�Physical Presence or Online Notarizatio
this qday of
Marl D Russ'<)
Name of person making statement.
f St.
consult
1�
*a'
2020 by
12
a00
=Ask -Non
Personally Known ✓ OR Produced ldentificatio
Type of Identification
Produced DC.
(Signature of Notary Pu(ilic- State of Florida) Signature of Notary Publics State of Florida )
Commission Na. � �3 21� (Sea!) i Commission No. 41 f's 2'� i"' (Seal).
REVIEWS
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW 1p
MANGROVE
REVIEW
ft