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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: Q063"65Cho
Fn
ECEIVED-
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Building Permit ApplicatiR I cJ?0
Planning and Development Services County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMITTYPE: ALUMINUM SCREEN ENCLOSURE
PROPOSED IN'PROVEMENT.LOCATION`'r
Address: 12790 NW Cinnamon WAY Palm City, FL 34990
Property Tax ID #: 4425-602-0033-000-5 Lot No. UNIT 34
Project Name: RUUD
DETAILED`DESCRIPTI;ON OF WORK f k
ALUMINUM SCREEN ENCLOSURE FOR SWIMMING POOL
CONSTRUCTION INFORMATION ^I
Utilities: _Sewer _Septic Sq. Ft. of First Floor:
Cost of Construction: $ Total Sq. Ft of Construction: 1960
k
FLOODPLAIN DEVELOPMENT PERMIT for structures exempt from Budding Code that are in the
Nonresidential Farrrf Budding, u Ternp ;Bldg /Sh.ed.used exclusively for construction
Mobile%Modular for=temp; construction office Bldg involved in distrib. of electricity
Other - Flood Zone:' BFE , Floodway? Y/N If Y -
No Rise Certificate with supporting data attached? Y/N
�Afl other applicable State and federal permits shall be obtained priorjto commericemerit of ,
construction.
OVI!-NER/LESSEE CONTRACTOR
Name Name: 616'i U G
Alan &Patricia Ruud
Address:12790 NW Cinnamon WAY Company: r; G 1!^ y C
City: PALM CITY, FL State: Address: I J ✓ r
Zip Code: 34990 Fax: City: or V,[ C7 State: f1
Phone No. 262-880-7917 Zip Code: 5q M Fax:
E-Mail: Phone No 7-1
Fill in fee simple Title Holder on next page ( if different E-Mail fyoocv ir►1 60e1 ri com
from the Owner listed above) State or County License
V.
f 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 CONSTRUCTI:dNL'IEN LAW IN"FORMATION
,
DESIGNER/ NGINE _Not"Applicable
MORTGAGE COMPANY:
Not Applicable
Name: f?dl U ,�i� 0
r.Jn mWtifName:
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 your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or a torney before
commencing work or recording your Notice of Commencement. _ /
ctor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S'i" l u 0 a,
The forgoing instrument was acknowledged before me
ti, day of PDfLM20L'_Z by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identificatio
Produced
r
o`�Ale>:afy Public- State of Florida )
Commission �Ijo. (Seal)
Signature
Holder
STATE OF FLORIDA
COUNTY OF Si ( L_u o _i -c
The forgoing instrument was acknowledged before me
this � day of V �t �n 20_` W by
rv-b,t !r C, 1 �Lks S G
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced 1Q,, C
0 -1 — Z -4
0 ^ C�' " UJ -
(Signature —of Nota Public- State of Florida )
Commission No. I) a01.3 (Seal)
, SARADONOV
N ALEXANDER
'_°�• ;y
•
Notary Public - Sta
a of Florida
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