HomeMy WebLinkAboutPermit Application - GagnonAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
p ° Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:screen room
PROPOSED IMPROVEMENT LOCATION:
Address: 14264 ISLA FLORES 1, t, c
Property Tax ID #: 1306-501-0543-000-8 Lot No.14264
Site Plan Name: Block No. 33
Project Name:
FDETAILED DESCRIPTION OF WORK:
BUILD SCREEN ROOM ON FRONT OF HOME UNDER EXISTING ROOF 18'X6'
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit — check all that apply:
Mechanical Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1850. Utilities: —Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameGHISLAINE GAGNON
Name:MATTHEW MARKS
Address:14264 ISLA FLORES
Company: EAST COAST ALUMINUM PRODUCTS
Address:913 EDWARDS RD.
City: FORT PIERCE State: _
Zip Code: 34951 Fax:
Phone No.448-8403
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-7603
E-Mail:
Phone No772-464-7600
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail ECAPINC@HOTMAIL.COM
State or County License24526
if value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is ,57,500 or more, a RECORDED Notice of Commencement is required_
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
...;4-k IAnr -,n n++nrrio„ hofnro rnmmPnrina %ninrk nr rPcnrrlinE vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF 9-7 LiLt ,C-
COUNTY OF S'Z t uciF
Swor o (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this _Z�k day of p►Ay 202f by
this 7k day of raj► 202f by
MA'rTWEW MAP.V.5
MA77/4EW MARK-'
Name of person making statement.
Name of person making statement.
�
Personally Known 11 OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
tLA A/o-*'
/yn4K
(Signature of Notary Public- State o ida TRUTH HOLMAN
(Signature of Notary Public- State )NOTARY PUBLIC
< NOTARY PUBLIC
Commission No. 73 4 V- E ( �0ATE OF FLORIDA
<
T TE OF FLORIDA
Commission No. 6C 4 "� 3 6 Yo Comm# GG973640
Cmvn# GG973640
ph es 3/26i2O-24--
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/ZU