HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 Commercial Residential x
PERMIT APPLICATION FOR: Aluminum without concrete
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Address: 6580 Dulce Real
Legal Description: Spanish Lakes Fairways Leasehold Estate(OR 2380-1934)That Part of SEC As Shown In Or 2380-1934
Being Lot 6580 Dulce Real (BLK 70 Lot 33) (0.13 AC-5663 SF)(OR 4490-2038)
Property Tax ID#: 1306-501-1004-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
91
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Installing a screen infill on the back of the home.
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Additional work to benertormed unclerthiS permit—crieck a apply:
❑HVAC Gas Tank Gas Piping _Shutters L1 Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1500.00 Utilities:oSewer Septic Building Height:
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Name Angela Holbrook Name: Jeff Jackman
Address:6580 Dulce Real Company: Master Craft Aluminum Products
City: Ft Pierce State:_ Address: 1634 SE Niemeyer Cir
Zip Code: 34951 Fax: City: Port St Lucie State:FI
Phone No.606-331-8073 Zip Code: 34952 Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page(if different E-Mail: mastercraftaluminum@gmail.com
from the Owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:AWW HWb=k Name:wrmm—
Address: ai Address:
City:— State: City: Po^�1,1 ucio State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:1634 SE Niemeyer Cir 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 an attorney before
commencing work or recording our Notice of Commencement.
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Signature of L ss e/Contractor as Agent for Owner Signat e n ra or/License Holder
STATE O ORIDA STATE OF FLORIDA
COUNTY OF Sf, U-fi-e COUNTY OF S'r• �L�r e--
The forgoing instrume t was acknowledged before me The forgoing instrurpent was acknowledged before me
this��xiay of_ fC+MA 20 Zi by this�A day of 0-e� YK4 tj 20 21 by
J'e�f ae,rn Je� �ackr�a
Name of person making statement Name of person making statement
Personally Known i/ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Pu c-State of Florida) (Signature of Notary Pu ic-State of Florida )
S�D.Moore
Commission No. rt 'gRY PUBLIC Commission No. (Seal)
STATE OF FLORIDA i$E
Sheryl D.Moore
-Comm#GG945237 NOTARY PUBLIC
wplU , Expires 1/15/2024 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIONrG ROVE
COUNTER REVIEW REVIEW REVIEW REVIEWI Eres / fW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17