HomeMy WebLinkAboutGrace Permit AppA!I APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Planning and Development Services
Building and Code Regulation Division Commercia I
Z300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential X
PERMIT APPL1cATION FOR:gluminum with®ut c®ncrete (in fill)
PROPOSED IMPROVEMENT LOCATION:
Address: 9 Tosca St Fort Pierce, FL
Property Tax ID #: 1301-111-0001-000-5
Site Plan Name; Lot 9 Street Tosca Spanish Lakes Country Club
Project Name: Grace
DETAILED DESCRIPTION OF WORK:
Install a 10' x 12' aluminum/screen enclosure in existing back covered patio (in fill only) �,h
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New Electrical Meter ____ Second Electrical Meter
Lot No.9
Block No.
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� CONSTRUCTION INFORMATION: �
Additional work to be performed under this permit— check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers Generator Roof
Total Sq. Ft of Construction: __ Sq. Ft. of First Floor:
Cost of Construction: $ 2,290.00 Utilities: _Sewer _Septic Building Height:
Pond
Pitch
OWN ER/LESSEE:
CONTRACTOR:
Name Kathleen Grace
Name: Michael J Newman
Address: 9 Tosca St
Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State: �1--
Zip Code: 34951 Fax:
Phone No.332-1261
Address: 1682 SW Biltmore St
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-340-4626
Phone No 772-340-4393
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail pioneerscreen@msn.com
State or County License FUC11066919
�� vaouc v� wnau u�uun is c�uu ur rnure, a rcccurcueu ivonce or commencement Is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTIO LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — of Applicable
MORTGAGE COMPANY: of Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: of Applicable
BONDING COMPANY: of 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 Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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.
Inconsideration 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 tice of Commencement must be recorded in the public records of St.
Lucie County and fisted on the jo ite before the first inspection. you intend t obtain financing, consult
with lender or ttorne b for cp'mmencin work or r_ecordi our Notice o Commencement.
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Signature of Owner/ Lessee ntract r as Agent for Owner
Sig at re of Contra or/Lice se Holder
STATE OF FLORID _
COUNTY OF �, Lt,f._C.%-�-
STATE OF FLORIDA
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COUNTY OF �-I- C t-C'
Sworn (or affirmed) and subscribed before me of
Sworn r affirmed) and subscribed before me of
Physical Presencelor Online Notarization
this �ay of,_� E��%I�,Pa`1,9,(�-��` 202b by
Physical Pre pce or Online Notarization
this,��`ay
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of , 202p by
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Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known `�/ OR Produced Identification
Type of Identific n
Type of Identification
.oduced
Produced
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(Sign e of Notary Pu � tat f��F f.�+-w�=:�
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(Signature of tary Pu lic ate "Flonda�j =� �,� ; �:��.
' £� J-. �Ioiary Public State of Flanoa z
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Com 'ssion No. (� .�# .,� `� ((-��i}}�� �
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Commission No. ���-��`��� � � �{SC�i�)��ene Newman
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Q � y Cbmrn!Ssion GG 221434
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Rev. 5