HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR
Date:
Permit Number: UAa
Building Perm it'Application per'�;ta
Planning and Development Services t. (Uc90epd�
Building and Code Regulation Division cDUnk
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, ,Iclick arrow at the end of line
PROPOSED IMPROVEMENT LOCATION - ,, //
Address: D/ -/IV e / /I
Legal Description: THE EAST 44.5' OF LOT 9 ALL OF LOTS 10.11 AND 12 BLOCK3 RUHLMAN
PLAT BOOK 9 PAGES 55 OF THE PUBLIC RECORDS OF ST LUCIE C(
Property Tax ID #: 340380500510009
Site Plan Name:
r-P' a
ACCORDING TO THE MAP OR PLAT THEREOF AS RECORDED IN
FLORIDA
Project Name:
Setbacks Front N/A Back: 46' Right Side: 113.3' i Left Side: 33'
I
DETAILED DESCRIPTION OF WORK:;
I
BUILDING SCREEN ENCLOSURE WITH SCREEN ROOF ON EXSISTING SLAB
Lot No.9,10,11,12
Block No.
;CONSTRUCTION INFORMATION
Additional work to be erformeaun er t is permit — c ec a apply:
❑HVAC Gas Tank ❑Gas Piping _Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 2350.00 LABOR ONLY
S Ft. of First Floor: _
Utilities:cn Sewer ❑ Septic
Building Height: 8-7"
gWNER/LESSEE:.-
CONTRACTO
Name
Address: _5 d VIP
Name: o U �'
Company: MARIO RUSSO ALUMINUM INC
91
City: / GO State:FL
34982
Zip Code: Fax:
Address: l'✓ y
T FL
City: �: r 5 VC � State:
Phone No.772-486-7716
Zip Code: 34983 Fax:
E-Mail:
Phone No. 772-370-8671
Fill in fee simple Title Holder on next page ( if different
E-Mail: russocustomflooring@yahoo.com
from the Owner listed above)
State or County License: 30367
IIf value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I
__J
SUPPLEMENTAL'CONSTR;UCTION'LlEN, LAWINFORMATION.,
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: SUNCOAST ALUMINUM ENGINEERING
Name:
Address: 13630 58TH ST. N. SUITE 101
Address:
City: CLEARWATER State: FL
City: State:
Zip: 33760 Phone727-532-9000
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
6ONDING COMPANY: Not Applicable
Name: T
i
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 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 inspe ' n. If you intend to obtain financing, consult with lender oyan attorney before
commencing workecorsl'ing vour Notice of Commencement. _ A
Signature of Contractor/License Ho
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
i
The f rgoing instr ent was acknowledged before me
thisday of�Y�CA , 20U by
this day of 20!f_ by
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1 , cjV U Y,JN O
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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 Identification
Type'of Identification
Produced
Produced
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DATE
RECEIVED
DATE
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Rev. 8/2/17