HomeMy WebLinkAboutWorley appAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEDPermit Number:Building Permit ApplicationPlonning ond Development SerylcesBuilding ond Code Regulotion Division COmmefCial2300 Virginio Avenue, Fott Pierce FL i4982Phone'.17721 462-!553 Fax: (7721 462-t578Residential xPERMIT APPLICATION FOR: ggfeen fOOmPROPOSED IMPROVEMENT LOCATION:4661955. 7707 Palomar St Fon Pierce, FL 34951Property Tax lD #:Site Plan Name:1301-603-0106-000-1Lot No. 19Block No.Project Name:DETAILED DESCRIPTION OF WORK:Extend existing concrete to 15' X 24' and a 3' x 4' stoop w/ 8" x 8" footerBuild a 15' X 24' screen room with an aluminum roof systemNew Electrical MeterSecond Electrical MeterCONSTRUCTION INFORMATION:Additional work to be performed under this permit - check all that apply:_Mechanical _ Gas Tank _ Gas Piping_ Shutters _ Windows/Doors - PondGenerator Roof Pitch_ Electric_ Plumbing _ SprinklersTotal Sq. Ft of construction:Sq. Ft. of First Floor:cost of construction: $ 10'750'00Utilities: _sewer _ Septic Building Height:lf yalue ot constructlon ,s 25ql or more, a RECoRDED Notke of Crmmencement is rcquired.lf value of HAVC is 57,500 or more. a RECORDED Notice of Commencement ls requhed.OWNER/LESSEE:CONTRACTOR:N2msBruce Worley466r"tr. 7707 Palomar StCity: Fort PierceState:zip code: 34951Fax:p1,ens t{6. 772-200-6504E-Mail:Fill in fee simple Title Holder on next page ( if differentfrom the owner listed above)Name. David F MillerCompany:A Quality Construction, LLCAddress. 3531 S 25th St.City: Fort PierceState: FLzip code: 34981Fax:phone No 772-343-0805E-MailState or County Licensec8c1257739ffffi[$;*
SUPPLEMENTAL CONSTRUCTION LIIDESIGNER/ENGINEER: _NotApplicableName: rhomas ahen[d 6lpg5 g ; sr,oo ua;m sr sre r r oCity: .r-p"State: FLPhOngsl3-37a+s16Zip::googMORTGAGE COMPANY:x Not ApplicableName:Address:City:State:Phone:Zip: _FEE SIMPIE TITIE HOTDER: x Not ApplicableName:AddrCity:Zip: -ress:Phone:BONDING COMPANY: x Not ApplicableName:Address:City: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 Countv makes no reoresentation that is srantins a oermit will authorize the oermit holder to build the subiect structurewhich is in conflict with any applicable Home owiers A<ociation rules, bvlaws or and covenants that mav restrict rir orohiblt suihstructure. Please consult with your Home Owners Association and review your deed for any restrictions raihich may afply.ln consideration of the grantinE of this requested permit, I do hereby agree that I will, in all respects, perform the workin 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 €oncurrency review: room additiontaccessory structuret swimming poolt fences, walls, signs, screen rooms and accessory uses to another non-residential useWARNING TO OWNER: You. fallure to Record a Notice o, Commencement maylmprovements to your property. A Notice of Commencement must beon the jobsite before the first inspection. lforin paying twice forrd in the public records of St.J to obtain financing, consultof Commencement.Lucie County andwith lender or anName of person making statement.Personally Known _ OR Produced ldentificationto (or affirmed) and subscribed before me ofPreqainqe gr _ Online NotarizationType ofl<[*rxar(Signature ofiH,lrt gtJrto*'' ^ Jt iucfi(or affirmed)and subscribed before me ofName of person making statement.OR Produced ldentif icatiol-z/,^ttEil.f6 f.. f-tr8-uy c",r,fl-Fpr,sr-ilii]'iaCOUNTY OF