HomeMy WebLinkAboutBUILDING PERMIT APPLICATION11111111
ALL APPiLI ABLE INFO MUST BE COMPII ru FOR APPLICATION TO BE ACCEPTED
Date: �10' c�� ' b Permit Number: r lSJ
I' SCANNED
BY . ..
waft
Building Permit ApplicatioLRECEiVED
AUG 2 4 2018
Planning and Development Services ucie County, Permltting
Buildingl and Code Regulation Division
11
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: 1(772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMI {APPLICATION FOR: Aluminum without concrete
PROPOSED'IIVIPROUEME.NT LOCATION ti
Address: 1132*S Indian River Dr Jensen Beach, FL 34957
I
Legal DesiCription: 9 37 41 BEG AT PT ON WLY R/W OF IND RIV DR 1420 FT SLY OF N BDRY OF SEC 9, TH RUN SWLY 150FT , TH NWLY 70 FT
TH SWLY 540 FT M/L TO ELY R/W FEC RR, TH SELY ALG SD R/W 305 FT M/L (See PA record)
pi Property Tax ID #: Lot No.
Site Plan I 4509-120-0012-000-0 Name: Leitch Block No.
Project Name: Leitch y-,
Setbacks'! Fron� Back: Right Side: nLeft Side:
DETAILED DESCRIPTLON.OF WORK.
Install a I aluminum/screen pool enclosure 27' x 43' with poly roof 27' x 14' on slab by pool company.
CONSTRUCTION INFO, MATION.
Additional work to e e orme under this permit— check a apply:
�HVAC Ei Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
Electric El Plumbing Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Co l struction: $ 17,240.00 Utilities: Sewer Septic Building Height:
I
OWNER%LESSEE'Audrey
Rollins Leitch
'CONTRACTOR:. Pioneer Screen Co. Inc.11
Name Audrey
Address: 1,f
City: Jensen
Zip Code:
Phone No.,804-512-7934
E-Mail:
Fill in fee
from the
Rollins Leitch
Name: Michael J Newman
3207 S Indian River Dr
Company: Pioneer Screen Co. Inc. II
Beach State: FL
;34957 Fax:
Address: 1682 SW Biltmore St.
City: Port St lucie State: FL
Zip Code: 34984 Fax: 772-340-4626
Phone No. 772-340-4393
1�
i
simple Title Holder on next page ( if different
wrier listed above)
E-Mail: pioneerscreen@msn.com
State or County License: RX11066919
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
_'VhR )'. RIII �_n 1n!2 11 11
CONSTRUCTI04
LIEN LAW�INFORMA_
TION. �: ', }z J 4r�
}SUPPLEryMENTAL
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
N a m e:
Do Kim & Associates
Name:
Address:
PO Box 10039
Address:
City. Tampa State: FL
City: State:
Zip: 3�I079 Phone 813.857.9955
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
BONDING COMPANY: %I Not Applicable
_
Name:
Name:
Address:
Address:
City: 11
City:
Zip:
I Phone:
I
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 folloLng building permit applications are exempt from undergoing a full concurrency review: room additions,
accesso II 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 V your property. Notice of Commencement must be r� rded and posted on the jobsite
before the fir nspection. If y intend to obtain financing, consult w,rf nder or an attorney before
comm6cin ork or recordi ent. � / your Notice of Commencem
"Signatuir&of Owner/ (lessee/C ntractor as Agent for Owner
STATE, OF FLORIDA
COUNTTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this h day of 20AI by
Michael J Newmna
Name of person making statement
Iv Known x OR Produced Identification
Type
Signabare
of Notary Public-S t of Florida )
:ommislsion
No -ter Public Stet®
rancene Newman
MY Commission GG 2;
Expires
cr no 05/23/2022
REVIEII
S
FRONT
ZONING
SUPERVISOR
COUNTER
REVIEW
REVIEW
Signaturepf Contractor/License Holder
STATE OF FLORIDA
COUNTY OF Saint Lucie
The forgoing instrument was acknowledged before me
this _JL day of 201Z by
Michael J Newman
Name of person making statement
Personally Known x . OR Produced Identification
Type of Identification
Produced
(Signatu a of Notary Public- State of Florida )
C mission No., GGG189:97w�� No�a�lic State of Florida
Fr nre :Newman
y4_.JMy Commission GG 221434
Expires 05/23/2022
PEGETATIEATURTANGRO
WU I VREV EWON I S REVIEWLE I MREV EWVE
DATE
COMPLETED
Rev. W/O