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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l �f
Date: �L' �l0 [ Permit Number: / <RECEIVED
Building Permit Application . FEB /6 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Aluminum without concrete
;PROPOSED:IM PROVEMENT=LOCATION.
Address: 1819 Hazelwood Dr Fort Pierce, FL 34982
Legal Description: Estates of Longwood-Lot 33
Property Tax ID#: 2433-502-0033-000-7 Lot No.33
Site Plan Name: Bausher Block No.
Project Name:
i �
Setbacks Front Back: 15; 0d Right Side: 5.5.5. Left Side: 9.43
DETAILED DESCRIPTION OF WORK
Install an aluminum pool enclosure 43' x 24' with poly roof 25' x 15' on existing slab/pool.
CONSTRUCTION INFORMATION
Additional work to e e orme under this permit—check all. apply:
HVAC Ei Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 9,500.00 Utilities:Sewer O Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Michael Bausher Name: Mlchael J Newman
Address:1819 Hazelwood Dr Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State:FL Address: 1682 SW Biltmore St
Zip Code: 34982 Fax: City: Port Saint Lucie State:FL
Phone No.595.5854 i Zip Code: 34984 Fax. 340.4626
E-Mail: I Phone No. 340.4393
Fill in fee simple Title Holder on next page(if different E-Mail: pioneerscreen@msn.com
from the Owner listed above) State or County License: RX11066919
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUFPLEIVIENTAL CONSTRUCTION LIEN LAIN INFORMATION
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Do Kim&Associates Name:
Address:Po Box 10039 Address:
City: Tampa State: FL City: State:
Zip: 33679 Phone: 813.857.9955 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 your pa mg twice for
improvement901r,
your property.A Notice of Commencement must be rded and post on the jobsite
before the f' spection. I u intend to obtain financing, consult it ender or an a ney before
comment' k or cor our Notice of Comme ent.
1
s
_Sig ature of Ow r/Lesse Agent Signat a of Contra r/Licens Holder
STA E OF FLORIDA STATE OF FLORIDA
COUNTY OF saint Lucie COUNTY OF Saint Lucie
The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me
this day of n . 20 I`7 by this l day of Jan 20 ``l by
Michael J Newman- Michael J Newman
(Name of person acknowledging) (Name of person acknowledging)
(Signature of N•t ry Public--State of Florida) (Signature of Notary ublic-State of Florida)
Personally Known X entification Personally Kno OR Produced Identification
Type of Identification Pr ets BEVFR�v c u,w� Type of Idea 'fi a du
ACE Is WALLACE
''' •e MY CO1�MM�I1 Com
�SION#GG023777 mission N MY Comm I8�IaN(s�b23777
Commission No. EE83025 -; EXPIr ovemberQ3,2020 �mEser 03,9020
Revised 07/15/2014,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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