HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /�J�i c► 91 l
Date: ts - Permit Number:
AIRM
Building Permit Application MAY - S` ��17
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
PERMIT APPLICATION FOR: Aluminum without concrete
PROPOSED IMPROVEMENT LOCATION:
Address: (S_03 y1evy" %-P_ 1 f,aw _Legal Description: ?lx*w LEA- I-S — (O . 341 AC l I(o2 W-
Property Tax ID#: S'iks -70G - 0o03 - oao - Lot No. )3Z
Site Plan Name: Block No.
Project Name: -��Zoh ��✓� es"'
Setbacks Front 125�_ 3a: /6- Side: 10 Left Side: 1 h
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit-check a tea apply:
❑HVAC Gas Tank ❑Gas Piping lul Shutters ❑Windows/Doors Aluminum
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: 3p0 Sq. Ft.of First Floor: 30(3
Cost of Construction:$ 2350 Utilities: []Sewer❑Septic Building Height: .5
OWNER/LESSEE: CONTRACTOR:
Name Name: Ray Edwards
Address: Cg'' O-S I��t,�c-ivLAw� 1 Urra c-c Company: Affordable Screen Rooms Company
City: eo-�-V -Sk Luc.. State:-a- Address: 613 SW Pueblo Terrace
Zip Code: ��`15"z— Fax: City: Port St. Lucie State:FL
Phone ._.4 Zip Code: 34953 Fax:
E-Mail: Phone No. 772 626-4495.
Fill in fee simple Title Holder on next page (if different E-Mail: ray@asrc.us
from the Owner listed above) State or County License: 29118
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: TC X Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: j<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 work or recording our Notice of Commencement.
s
_Signatu of Owner/Less Agent Sig ractor/License Holder
STATE FLORIDA STATE OF FLORIDA
COUN OF -S I (-L�Ci� COUNTY OF 37 - LuC/C
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this__L day of 20 L2by this r day of 4l 1J -f 20/`7 by
I_0N4N J lkcoPrt' PGc�+a 2Awc s
(Name of person acknowledging) (Name of person 2ckn6wledging)
(Signature of Notary Pub tic-State of Florida) (Signature of Notary Public:-State of Florida)
Personally Known �/ OR Produced Identification Personally Known ✓ 0 '
YP Type of Identification P
Type of Identification Produc :ot "• PATRI'CIA STEVENSMY COMMISSION#GG0237
Commission No. MY COWI§PION#GG023715 Commission No. 1'MWF �R��S September 19,20
�„� ,�.� EXPIRES September 19,2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW. REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS