HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICAT
Date: SCANNEG
Building Perm
TO BE ACCEPTED Q
Permit Number:
RECEIVED
it 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
MA 1.6 1010
Permitting Department
St. Lucie County
Residential X
PERMIT APPLICATION FOR: Aluminum without concrete
FROPOSEDJ PROVEMEIVTiO`CATION �.
Address: 5409 S Indian River Dr Fort Pierce, FL 34982 1
Legal Description: Plat of S 614.21 ft of Gov Lot 1 of Sec 1*36-40 N 150.1 ft of 5414.11 ft LYG E of FEC RR R/W less RD R/W and less that part of
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Gov Lot 1. MPDAF:From WLY of Indian River Dr and A PT 414.1, 1 ft of S LI of Gov Lot 1
Property Tax ID #- 3401-604-0003-000-5 Lot No.1
Site Plan Name: Boykin Block No.
Project Name:
Setbacks Front 19 E5t Back: 210t Right Side: Left Side: (1 i
rDETAILED DE$;CRIPTION OF VI(O.RK =G r
Install a poly roof 17' x 22' on existing patio.
CONSTRUCTION INFORMATION
Additional work to be performed under this permit- check all apply:
HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers FIGenerator F Roof Roof pitch
Total Sq. Ft of Construction: S FtFt . I . of First Floor:
Cost of Construction: $ 5,800.00 Utilities: — Sewer - Septic Building Height:
O-1NNER/LESSEE ', ° ,.
, . ,/LE
CONTRACTOR: a_ '
Name Dr. Ian Boykin
Name: Michael J Newman
Address: 5409 S Indian River Dr
Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State: FL
.Zip Code: 34982 Fax:
Phone No. 528.2647
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:
stllate
pioneerscreen@msn.com
or County License: RX11066919
If value of construction is $2500 or more, a RECORDED Notice of Con%mencement is required.
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_
SUPPLEMENTAL CONSTRUCTION L''EN LAW INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
Name: 1D0 k j >\ a )� SSDC-
... .
MORTGAGE COMPANY: Not Applicable
Address: - 015 l D� 3�
Name:
Address:
City: � ^ C� State:
Zip: �io7! j Phone: Y57-C�5� l
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: i✓ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
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 I ill 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 full
a concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen r and accessory uses to another non-residential use
ioms
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 f•rst inspectio . If you intend to obtain financing, consult ith lender or an attorney before
'
co en work or r ordin our Notice of Commencement.
s
Sign ure of O er/Less a/Contractor as Agent for Owner
Signat
re of Cont ctor/ icense Holder
STATE OF FLOR.� r
COUNTY OF J-nA r CLn '?) i Je-'f
STATE
COUNTY
OF FLO A
OF h(\Nan q � Ve- Y
forgoing instrument was acknowledge efore me
The for oing instrument was acknowledged efore me
this f day Y-n
The
of a r Ch . 20 b y
this
� dayof_ Mar� 20 1 by
tie-hCL k J • �e-u)mar,
1y)'1C.h'Qe-1 -J.�&3man
(Name of person acknowledging)
(Name of person acknowledging)
9 �.
(Signature of Not ry Public- State of Florida)
(Signature of Not Public- State of Florida )
Personally Known '� OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No. (Seal)
BEVERLY S WALLACE
�:
Col mission No. .';+f
VERLY g WALLAC
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MY
=. COMMISSI E
# GG023777
Revised 07/ 5/���, EXPIRES November 03, 2020
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����� PIRES N°Ve►nber 03 2p20
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
DATE
REVIEW
COMPLETE
INITIALS
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