HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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 Residential x
PERMIT APPLICATION FOR: Aluminum without concrete
Address: 26 Montoya, Ft Pierce, FI 34951
Legal Description: Spanish Lakes Country Club Village Leasehold Estates (OR 2389-639) That Part of SEC As Shown
In OR 2389-639 Being Lot 26 Montoya (0.11 AC-4792SF)(Or 4480-231)
Property Tax ID #: 1301-500-0821-000-3
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
Installing a screen infill under the existing truss roof of the back of the home.
Lot No.
Block No.
Haaitionai worK to pe ertormea unaer tnis permit — cnecK an apply:
E1HVAC Gas Tank Gas Piping In Shutters ❑ Windows/Doors
11 Electric ❑ Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 1700.00 Utilities:Sewer Septic Building Height:
Name Kim Jornov
Address: 26 Montoya
City: Ft Pierce State:
Zip Code: 34951 Fax:
Phone No.845-303-0541 .
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name: Jeff Jackman
Company: Master Craft Aluminum Products
Address: 1634 SE Niemeyer Cir
City: Port St Lucie State. FI
Zip Code: 34952 Fax: 772-335-0860
Phone No. 772-335-1177
E-Mail: mastercraftaluminum@gmail.com
State or County License: SCC131150586
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
City: State:
Address:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: ADDllcation is herebv made to obtain a oermit 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 herebyagree 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 vour Notice of Commencement.
Signs re O er/ Les ee/Contractor as Agent for Owner
Signs re of o dor icense Holder
STATE OF FLORIDA
S'� (-r
STATE OF FLORIDA
COUNTY OF
COUNTY OF Sfi �fxc� G
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of October 202 by
this 6 day of October 20-2-1 by
Name of person making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary ublic- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. GG915 93T (Sea!)
Commission No. GC,gyS 23 (Seal)
Sheryl D. Moora
kkRyA._Sheryl D. Moore
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DATE
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pires 1/15/2
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pires 1/15/202
RECEIVED
DATE
COMPLETED
Rev. 8/2/17