HomeMy WebLinkAboutBuilding Permit ApplicationF
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: APRIL 17, 2021 Permit Number:
�`1 Co I�LIGQG WEWIVED
o
Building Permit Application JUN 17 2021
Planning and Development Services SL Lucie County
Building and Code Regulation Division Commercial Residential Permion9
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:SCREEN ENCLOSURE REPLACEMENT
PR6POS0)M PROVEMENT.L`OCATI:ON
Address: 76 GOLF DRIVE
Property Tax ID #: 3414-501-1701-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
DETALLED DESCRIPTION `OF 11U'ORK ;` r
INSTALL AN ALUMINUM SCREEN ROOM ENCLOSURE ON AN EXISTING SLAB
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: 200
Cost of Construction: $ 2400.00
Sq. Ft. of First Floor: _
Utilities: —Sewer _ Septic
Building Height: 10,
CONTRACTOR:
Name DWAYNE BUCHHOLZ
Name: OWNER
Address:76 GOLF DRIVE
Company:
City: PORT ST LUCIE FL State: _
Address:
Zip Code: 34952 Fax:
City: State:
Phone No.771-631-9068
Zip Code: Fax:
E-Mail:SOJACKED@GMAIL.COM
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail
from the Owner listed above)
State or County License
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
.,
r:
DESIGNER/ENGINEER:
x� Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
x Not Applicable
BONDING COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
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 anyi applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult w th 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
with lencMr or an attorneubeforetommencine work or recording vour Notice of Commencement.
Sig ature of r/ Les ee/Cont or as Agent for Owner
Signature of Contractor/License Holder
STATE O LORIDA //
STATE OF FLORIDA
__.
COUNTY OF
COUNTY OF
Swor r affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
Physical Presence or Online Notarization
this (t day of 2020 by
this day of . 2026 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced IdentificationJS
Personally Known OR Produced Identification
Type of Identificatio
Type of Identification
Produced
Produced
(Signature of Notary Public- Stat of Florida)
"�;;(Signature
of Notary Public- State of Floridacn
Commission No. (Seal)
K.Commission
No. (Seal)
m0�
d3REVIEWS
FRONT
ZONING
SU
PIPLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
R
o C
ni
REVIEW
REVIEW
REVIEW
REVIEW
DATE
C. W T
RECEIVED
N V
DATE
Er
COMPLETED
ev.