HomeMy WebLinkAboutBuilding Permit Application I
I.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date:
( _ Permit Number: �-� Q" 671c0 n
`�1
I -
Building Permit Application
IPlanning 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 x
PERMIT APPLICATION FOR: Aluminum with concrete
Address: 120 NE Caprona Ave, Port St Lucie, FI 34952
River Park Unit 4 BLK 41 Lot 6 Ma 34/28N Or 3988-1631
Legal Description. p )( )
Property Tax ID#: 3419-530-0266-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
1Setbacks Front Back: Right Side: Left Side:
I
101
:w MAE.:'.Se.
installing a 22 x 17 screen room with concrete on the back of the home.
i
3-.....,-
ditional or to «e ertormed un er t us permit—cheCK all apply:
❑HVAC Gas Tank _ Windows/Doors
QGas Piping Shutters Q . ., .
ElElectric Q Plumbing Sprinklers Q Generator Q Roof Roof pitch "
Total Sq. Ft of Construction:. S . Ft.of First Floor:
Cost of Construction: $ 9500.00 Utilities: _Sewer Septic Building Height:
Name Earle MacFarlene Name: Jeff Jackman
Address:120 NE Caprona Ave Company: Master Craft Aluminum Products
City: Port St Lucie State:_ Address: 1634 SE Niemeyer Cir
fZip Code: 34983 j Fax: City: Port St Lucie State:FI
Phone No.321-360-6326 Zip Code: 34952 Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page(if different E-Mail: mastercraftaluminum@gmail.com
from the Owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
1 �
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: ,
Address• Address: 4wawPew==ae
City:-- State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ---.,-Not Applicable
Name-
Name:
Addres 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.
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.
Signat o ee/Contractor as Agent for Owner Sign a of t ctor icense Holder
STA LORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this,7�day of �✓ 20� by this Z'Z. day of p(�,+�n-y1•-2f 2UL� by
Name of person aking statement Name of person making statement
Personally Known VOR Produced Identification Personally Known t/ OR Produced Identification
Type of Identification . Type of Identification
Produced Produced
(Signature of Notary ta$gwpWoNbA►}3 (Signature of No c NOTARY PUBLIC,
s NOTARY PUBLIC — -+STATE OF FLO .�
Commission No. o< -+STATEOF(ISKAIDA Commission No.
?Comm#GGS45237 omm#GG945237
. El Expires 1/15/2024 ip a�s� Expires 1/15/2024
REVIEWS FRONT ZONING' SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17