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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application o-Z A yVE®
Planning and Development Services NOV 2 7
Building and Code Regulation Division 2017
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidlN'` ` 'fir
PERMIT APPLICATION FOR: Aluminum with concrete El
PROPOSED IMPROVEMENT LOCATION.__
Address: 9505 POINCIANA CT, FT PIERCE, FL 34951
Legal Description: MONTE CARLO COUNTRY CLUB UNIT TWO LOT 195
Property Tax ID #: 133450200760003 Lot No.195
Site Plan Name: Block No.
Project Name:
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK;
BUILD ALUMINUM NON -SUPPORTING SCREEN WALLS UNDER THE REAR TRUSS COVERED
PATIO, STRIP CONCRETE FOOTING FOR THE NEW WALL ATTACHMENT APPROX 50 LF
CO. NSTRUCTION INFORMATION:
❑HVAC Il Gas Tank
0 Electric El Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 4800.00
this permit — checK a app y:
❑Gas Piping _ Shutters
❑Sprinklers 0 Generator
S Ft. of First Floor: _
Utilities: Sewer 1:1Septic
Windows/Doors
Roof Roof pitch
Building Height:
OWNER/LESSEE;. _ .
CONTRACTOR: _
Name FRED WHITFORD
Name: CLIFFORD WELLS
Address:9505 POINCIANA CT
Company: TREASURE COAST HOME IMPROVEMENTS, INC
City: FT PIERCE State: FL
Address: 873 SW CAILFORNIA BLVD
Zip Code: 34951 Fax:
City: PORT ST LUCIE State: FL
Phone No.303-905-4238
Zip Code: 34953 Fax: 772-673-3783
E-Mail:FWHITFORD@COMCAST.NET
Phone No. 772-263-9287
Fill in fee simple Title Holder on next page ( if different
E-Mail: CLIFFW5050@GMAIL.COM
from the Owner listed above)
State or County License: CRC 057901
If value of construction is 92500 or more, a RECORDED Notice of Commencement is required.
`SUPPLEMENTAL CONSTRUCTC 1\111EN -LAW INFORMATION:
DESIGNER/ENGINEER: _
Name: So v — ; �'
Not Applicable
''
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:272fr,S--gM;a.tii -rrt
City: P�y�a,�-fin
Zip: Phone 99i -gs6
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
City:
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 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 your Notice of Commencement.
Signature finer/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF Ek Lvcie
The forgoing instrument was acknowledged before me
this day of , 20_ by
. J as)4
NM; of person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
re of Notary PublicyState of Florida )
Commission No.
LASHAHNAINGRAM
Notary Public - State of FI
x
Signature of CoryE¢�c)tor/License Holder
STATE OF FLORIDA ,
COUNTY OF S1- Lu c(cu
The forgoing instrument was acknowledged before me
this day of . 20_ by
Namly person making statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Notary Public- tate of Florida )
Commission No. (Seal)
LASHAHNa
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DATE
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RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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