HomeMy WebLinkAboutBUILDING PERMIT APPLICATION. i I
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;'r LIST BE CCOP,IPLETED FOR APPLICATION TO BE ACCEPTED
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II C'ele: _ SCANNED Permit Number:
II BY
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a . - St Lucie County RECEIVED ��
Buildi.ng Permit Application
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Planning and Developmeriit Services
Building and Code Regulation Division LST- Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 349821
Phone: (772) 462-1553 IFax- (772) 462'I 1578 Commercial Residential x
PERMIT APPLICATI&IN FOR: To Select from dropbox, click arrow at the end of line Screen room
PROPOSED IMPROVEMENT LOCATION:
Address: 4 Do_ n Qlluixote Lane, Port St. Lucie FL
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Legal Description: _ 27 i& 40 All that peort lyg E & _N 0f fit &
Property Tax ID#: 34 .7-1 1 1 -0002-000/_9
Site Plan Name: _ Spanish Lakes Riverfro
Project Name:
Setbacks Front_ I, Back: Right Side
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DETAILED DESCRIPTION -OF WORK:
Left Side:
Install tlwo wall screen room on rear of the home
with cc14osite roof system. Concrete is existing.
Lot No.
Block No.
CONSTRUCTION INFORMATION:
ItlOna workto be cI iu�meu ulluei un5 Neirnit— cnecl<an that apply:
�HVAC Gas Tank ]Gas Piping ❑_ Shutters a Windows/Doors
Electric ❑ Plu!nbing Sprinklers ❑ Generator ❑ Roof
Total Sq. Ft of Construction: I Sq. Ft. of First Floor:
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Cost of Construction: $ 2 , 4 00.00 Utilities: E]Sewer E]Septic - Building Height:
OWNER/LESSEE: I
CONTRACTOR:
Name Rnhprt & ynithia LaBtode
Name: Jeff TAckman
Address:4 Don Ouixotl'e Lane
Company: Master Craft Aluminum Produc
City: pnrt St. Lucl. State: FL
Zip Code: 34952 Fax:
Phone No.413-347-0331
Address1634 SE Niemeyer Circle
City: Port St. Lucie State: FL
Zip Code: 34952 Fax: 335-0860
Phone No335-1177
E-Mail a Si-r-rcra fi-al imi n um@gm i 1 com
State or County License: SCC131150586.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed abovei)
• VI IIIUIc, a Rr_%_U lUCU rvouce or L-ommencementis required.
;J .fr rL=ivtLty i.=;L
-N /ENGINE
t FI.Me: Surl
#j '.c 0ress:13630 5
lri City. Clearwa
Ej yip:._._33760 P
FEE SRAPLE TITLE
'Name:
Address:
City/:
Zip:
OiVS TRI.iC'111ON LIEN LAW INFORMATION:
_'Not Applicable
x State: FL
ne: 722-532-9009
LDER: x Not Applicable
Phone:
MORTGAGE COMPANY: x Not Applicable
Name: _
Address: _
City: State:
Zip: Phone:
BONDING COMPANY: . x Not Applicable
Name: _
Address:
City:_
Zip:
Phone:
I certify that no work or i' stallation has commenced prior to the issuance of a permit.
St. Lucie County makes nc representationithat 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 a, proved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building pe Imit applications) are exempt from undergoing a full concurrency review: room additions,
accessory structures, swi ming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNE,: 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 or1recording your Notice of Commencement.
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_ Sig tur o wner Lessee/Agent Signe rt r/License Holder
STA STA
COUNTY OF St. Lucile COUNTY OF St. Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this26 day of March 2V 18 by this 26 day of March -)p18 by
Jeff J,a::kman Jeff Jackman
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pub �i - State of Florida )
Personally Known X I OR Produced Identification
Type of Identification Prp� SRO'.._
Commission No. •a STATE
1I15/2020
Revised 07/15/2014
A4_&.L4D" .
(Signature of NotaryPublic- State of Florida )
Personally Known X dMffxlQr ion
Type of Identification Pr' NOTARY PUBLIC
STATE OF FLORIDA
Commission No. Co MIRIM
Exp M 1115=20
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