HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED u r
Date: 51 51 ,1 Permit Number:
RECEIVED MAY 0 5 2017
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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
FfPCtSED0I Et7VEMT C►CATt1 � _
Address: 1621 MALLARD CT FT PIERCE FL.34982
Legal Description. NORTH FORK ESTATES LOT 21
Property Tax ID#: 3409-503-0024-000-2 Lot No.21
Site Plan Name: Block No.
Project Name: NORTH FORK ESTATES
Setbacks Front Backe Right Side Left Side: L4_1.13 I
NOR,'
INSTALL A NEW 21 FT X 43 FT X 32 FT X 9.50 FT HIGH POOL SCREEN ENCLOSURE.
N
itiona wor to e e orme un ert IsJpermit—c eck all apply:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: 1376 S . Ft.of First Floor:
Cost of Construction:$ 8850.00 Utilities:Sewer E]Septic Building Height:
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Name BRIAN FOGAL Name: VAUGHN HOSKINS
Address:1621 MALLARD CT. Company: V H EXTERIORS INC
City: FT PIERCE State:FL Address: 543 NW WAVERLY CIR.
Zip Code: 34982 Fax: City: PORT ST. LUCIE State:FL.
.Phone No. Zip Code: 34983 Fax: 772-871-2567
E-Mail: Phone No. 772-871-6484
Fill in fee simple Title Holder on next page(if different E-Mail: vhexteriorsinc@gmail.com
from the Owner listed above) State or County License: 21579
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: SUNCOAST ALUM.ENG. Name:
Address:13630 58TH ST. Address:
City: CLEARWATER State: FL. City: State:
Zip: 33760 Phone: 727-532-9000 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 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 wor or recording our Notice of Commencement.
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Signature of Owner/Le see/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST LUCIE
The for oing instrument wws acknowledged before me The forgoing instrumentaaas acknowledged before me
this a day of fil,T C-, I . 20 P by this 3.y day of 0'0 1 .20 19 by
11 ()SM x 15 \1 Fit %i1N `4OSki"o Is
(Name of person acknowledging) (Name of person acknowledging)
RIVA � W A r1
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally KnowV OR Produced Identification
Type of Identification Produced Type of Identification Produced 1
Commission No.r S�,2 6 (Seal) CommissjgC 0. I (Seal)
`,�O1Y Pjj•.,,,, JEAN RALPH GACHETTE
MY UMMISSION#F 152211 it�lwasnsa
Revised 07/15/2014 '' °' EXPIRES:August 18,2018 ,b�� F� :, ,si n
Af h" Bonded Thru Notary Publio Underxriters Nf 4 `', �ondlf�l�fft It C19
— ry util c Unde�wr tens
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE rQ
INITIALS