HomeMy WebLinkAboutBuilding Permit Application, pg 2All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
L �� C(D IJTkL' i
Ca L CC 5
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
PERMIT APPLICATION FOR: SCREEN ROOM
PROPOSED IMPROVEMENT LOCATION:
Address: 3112 S 22ND ST.
Property Tax ID #: 2428-602-0045-000-5
Site Plan Name.
Project Name:
DETAILED DESCRIPTION OF WORK:
Residential X
BUILD 2 WALL SCREEN ROOM W/ 3" POLY ROOF ON EXISTING CONCRETE 15'X33'
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 9850.0
OWNER/LESSEE:
Name ROBERT RICHARDSON
under this permit— check all that apply:
_Gas Piping
_ Sprinklers
Address: 3112 S 22ND ST.
City: FORT PIERCE State:
Zip Code: 34982 Fax:
Phone No. 812-1221
Shutters
Generator
Sq. Ft. of First Floor:
Windows/Doors
Rood
Lot No. 20
Block No. 2
Utilities: Sewer � Septic Building Height:
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above
CONTRACTOR:
N a m e MATTH EW MARKS
Company: EAST COAST ALUMINUM
Pond
Pitch
Address: 913 EDWARDS RD
City: FORT PIERCE State: FL
Zip Code: 34982 Fax: 772-464-76003
Phone No464-7600
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 $7,500
or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable ,I -
MORTGAGE COMPANY: Not Applicable
Name: FLORIDA ALUMINUM ENGINEERING Name:
AMire$5:5601 MARINER ST,
City. TAMFA State: FL
Zi P aasos Ph0112B13-374-2403
FEE SIMPLE TITLEHOLDER: _Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
Zip: _
State
Phone.
BONDING COMPANY:
Name;
Address:
City:
zip: Phone:
_Not Applicable
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
�mprovements 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
with lender or an attorney before commencing work or recording Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF S T L U-C f�
Sworn t or affirmed) and subscribed before me of
hystical Presence or Online Notarization
this ///;1fiay of &A x 2021 by
Aj
/1 At jr
Name of person making statement.
Personally Known ��0 R Produced Identification
Type of Identification
Produced
(SigKature of Notary Public -
Commission No.
State of
ida )RUTH HOLMAN
4 NOTARY PUBLIC
ATE OF FLORID
GG973640
A.Or 'M4 Pft Y
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF QT. Luc
Swor o (or affirmed} and subscribed before me of
PhYsical Presence or Online Notarization
this Ic�day of MAY , 202JV by
70c;v M/a"s
Name of person making statement.
Personally Known I..., OR Produced Identification
Type of Identification
Produced
v
(Signature of Notary Public- State of Florj
Commission No.4:4r 473OC �eO
t9
RUTH HOLMAN
NOTARY PUBLI
STATE OF Fk.C? IC
C�CorwivCy9736 0
ie
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETE
Rev. S/6/20
12