HomeMy WebLinkAboutapp11 APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r O
Date: Permit Number:
Building Permit Appli
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
II PERMIT TYPE: Screen Room
PROPOSED IMPROVEMENT LOCATION:
Address: 610 Willow Ave Port St Lucie, FL 34952
Property Tax ID #: 3419-510-0243-000-6
Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
Build a 12' X 22' screen room with an aluminum roof on existing concrete
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Mechanical
Electric
_ Gas Tank
_ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 5,775.00
Gas Piping
_ Sprinklers
RECEIVED
AUG 01 2019
ST. Lucie County, Permitting
Residential X
Lot No. 12
Block No. 19
Shutters ^ Windows/Doors
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kevin O'Connor
Name: David F Miler
Company: A Quality Construciton
Address:3531 S 25th St .
Address:610 Willows Ave
City: Port St Lucie State:
_
Zip Code: 34952 Fax:
City: Fort Pierce State: FL
Phone No.772-206-6739
Zip Code: 34981 Fax: 772-461-3038
E-Mail:
Phone No 772-343-0805
E-Mail Aquality0l@bellsouth.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License CBC1257739
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: — Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: ThomasAmett
Name:
Address:
Address: 544OMarinerSt
City: State:
City: Tampa State: FL
Zip: Phone813-374-2403
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ^ Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 ONJHE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU 1 ND TO OBTAIN FINANCING, CONSULT
WI1TH YOUWEENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
of Own er7 Lessee/Contractor as Agent for Owner I Signatup6of Contractor/Licenpe Holder
STATE OF FLORIDA I' STATE OF FLORIDA I
COUNTY OF �) C . L C I �', COUNTY OF
The f rgoing instr � ent}Qras acknowledged before me The forgoing inst� ment was acknowledge before me
this � day of U 204 by this day of 20� by
—t-- _ _ , r 1 _
Name of person making statement. I Name of person making statement.
Personally Known OR Produced Identification Personally Known _
Type of Identification Type of Identification
Produced 2 1 Produced
OR Produced Identification
(Signature of No -
`O,�pRY FVe� A EN S. NIELSEN
(Signature of
PVe� KAREN S. NIELSEN
:State m sijr a�-t otary Public
Commission No. •= missidd G 207484
����RY
,a° State of Florida- Public
Commission _ _ �9€U4
�fo„�o My Commission Ex ires
p
fission # G 207484
'�� °' M Commission
June
%i;occ�o� y Expires
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