HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' �' %� Permit Number: �''y't"a--7.
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Building Permit Application JUN 2 0 2017
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
`iPROPOSED IM'PROUEMENT LOCATION' {
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Address: 5810 Balsam Dr Fort Pierce, FL 34982
Legal Description: Indian River Estates - Unit 09 - Blk 80 - Lot 5
Property Tax ID #: 3402-610-0306-000=1
Site Plan Name: Baeshore
Project Name: • '
Setbacks Front N Pi Back:
Right Side: �) l Left Side:
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Remove & reinstall screen enclosure 26' x 12' and 13' x 12' on existing slab.
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Lot No.15
Block No. 80
CONSTRrIJCTION INFORMATION
,itiona
F
ACIClwor to e e ormeunder
tispermit—check
all
apply:.
❑HVAC
Gas Tank
❑Gas Piping
_
Shutters
❑ Windows/Doors
❑ Electric ❑Plumbing
❑Sprinklers
❑ Generator
Roof Roof pitch
Total SgFt of Construction:
S . Ft. of First Floor:
Cost of Construction: $ 6,100.00
Utilities. ❑ Sewer ❑ Septic
Building Height:
OWNER/LESSEE
CONTRACTOR,' `
Name Terry & Joyce Baeshore
Address: 5810 Balsam Dr
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.460.0576
Name: Michael J Newman
Company: Pioneer Screen Co. Inc. II
Address: 1682; SW Biltmore St
City: Port Saint Lucie State: FL
Zip Code: 34984 Fax: 340.4626
Phone No. 340,4393
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Pioneeerscreen@msn.com
State or County License: RX11066919
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFORMATION;
DESIGNER/ENGINEER: Not Applicable
Name: Do Kim BAssociates
MORTGAGE COMPANY:
Name:
x Not Applicable
Address: Po Box 10039
City: Tampa State: FL
Zip: 33679 Phone: 813.857.9955
Address:
'
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
x Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 )Jotce of Commencement must be rpforded and posted on the jobsite
before the fir inspection. If you ifftend to obtain financing, consult lender oil attorney before
commencin ork or recording ur Notice of Commencement.
STAKE OF FLORIDA
COUNTY OF SaintLude
0-1
as Agent for Owner I Signat� re
STATE OF FLORIDA
COUNTY OF Saint Lucie
The fo{ oing instrument was acknowledged before me I The forgoing instrume as acknowledged before me
this .0 day of -54n.2 20 !' l by this 19 day of J Len e— 20 % 1 by
Michael J Newma� Michael J Newman
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notaryj`�ublic-State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. GG023777 -
Revised 07/15/2014
QQ-ce,
(Signature of No—ta—i Public- State of Florida )
Personally Known x OR Produced Identification
Type of Identification Produced
Commission No. GG023777
BEVERLY S WA LACE
AT MISSION # GG023777
EXPIRES November 03, 2020
(Seal)
BEVERLY S WALLAcE
MY COMMISSION # GG023777
EXPIRES November 03, 2020
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