HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONSCANNED �J
ALL APPLICABLE INFO MUST BE COMPLETED FOR aPPI:id6feNGeO ACCEPTED
Date: Permit Number:
• RECEIVED
Building Permit Application jut is I"
Planning. and Development Services artment
Building and Code Regulation Division permitting Dep
2300 Virginia Avenue, Fort Pierce FL 34982 st, i_uue County
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
'PROPOSED IMPROVEMENT LOCATION :, v
/ 4
Address:' si' l cam/
Legal Description: lot 30 sweetbay village as recored in plat b 2 p6'accroding tot the plat thereof on file in the clerks of the cc
Property Tax ID #: 442680300530001 Lot No.30
Site Plan Name: ' �%% Block No.
Project Name:
Setbacks Front25 Back: 4(5ZO Right Side: 15 Left Side: 1
DETAILED DESCRIPTION COF WORK
screen room with pavers ',4-- can
CONSTRxUCTI'ON IN,FORMATI01 3
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Additional work t0 be nertormed under this permit —check all app y:
11HVAC Gas Tank ❑Gas Piping _ Shutters ; Q Windows/Doors
11 Electric 0 Plumbing Sprinklers O Generator g Roof Roof pitch
Total Sq. Ft of Construction: 700 S Ft. of First Floor:
Cost of Construction: $ 12500 Utilities: Sewer O Septic Building Height: 8
OWNER/LESSEE:
CONTRACTOR:ot .` :.
Namef•
Name: Ems` C.CS
Address:
Company: 'gold standardconstruction
City: /��gs�r%
State fl
Addiess:�7c1 QAlA—A_—A 1ale—
Zip Coded Fax:
City: �� State: fI
Phone No 617` ,3
�(`� 9y
Zip Code: 34997 Fax:
Phone No. 772 2212116
E-Mail:mgcg673@me.com
Fill in fee simple Title Holder on next page (if different
E-Mail: sandersscreening@yahoo.com ,
State or County License: crc1330584
from the Owner listed above)
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
N a m e: rl engineering
Ad d ress: 4456 TAMIAMI TRAIL UNIT B14
City: PORT CHARLOTTE State: FL
Zip: 33980 jPhone9413915980
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address:
City:
Zip: Phone:.
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
State:
Not Applicable
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 of Owner/ Lessee/Contractor as Agent for Owner
Signature of ntractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF�,w
The forgoing instrument was acknowledged before me
The forgoing instru ent was acknowledge before me
this � day of 20]S by
this 1 day of 20 by
Name of person making statement \
Name of person making statement
Personally Known OR Produced Identificatioy
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- Sta-1 of Florida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
LASHAHNAINGRAM
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Dec 20 2018
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RECEIVED
,
DATE
COMPLETED
Rev. 8/2/17