HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONC
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 .q' �;og' IV. Permit Number:
ER(Std
E®
Building Permit Applicati
Planning and Development Services 8
Building and Lode Regulation Division drtment
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ltx, FL
PERMIT APPLICATION FOR: Aluminum without concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 9106 Champions Way Port St Lucie, FL 34986 �/>//��
Legal Description: LAKES AT PGA VILLAGE BLK B LOT 23 4UCi
°untl.
Property Tax ID #: 3334-501-0101-000-1 Lot No. 23
Site Plan Name: Spencer Block No. B
Project Name: Spencer
Setbacks Front Back: 16.OZr Right Side: 7.,79 f Left Side: $. 6
DETAILED DESCRIPTION OF WORK:
Install a 40' 4" x 17' aluminum/screen pool enclosure on slab by pool company.
�em1 Er-r,-� + I*�)a. 0\/00-
CONSTRUCTION INFORMATION:
Additional work to e e orme under tispermit—checka apply:
�HVAC E] Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: ScFt. of First Floor:
Cost of Construction: $ 9,619.00 Utilities:Sewer 0Septic Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name James and Karen Spencer
Name: Michael J Newman
Address: 9106 Champions Way
Company: Pioneer Screen Co. Inc. II
City: Port St Lucie State: FL
Zip Code: 34986 Fax:
Phone No. 907-841-4895
Address: 1682 SW Biltmore St
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-340-4626
Phone No. 772-340-4393
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: pioneerscreen@msn.com
State or County License: RX11066919
It value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL'.CONSTRUCTION";LIENiLA
I INFORMATION
DESIGNER/ENGINEER: _ Not Applicable
N ame• Do Kim a Awadatas
MORTGAGE COMPANY:
Name:
_ Not Applicable .
Address: Po Box 10039
Address:
City: Tampa State: FL
Zip, 33679 Phoneai3-957-9955
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
Not Applicable
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 .o
makes no representation that is'granting a permit will authorize thepermitholder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylawsr an 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
improvement$ to your properW.q Notice of Commencement must be r orded and p sted on thejobsite'
before the fj1�St insp ion. If o ntend to obtain financing, consult ysi lenfier or attorney before
co Jo work or re or m vour Notice of Commencement. 11
Signa ure of Ow er/ es a Contractor as Agent for Owner
Signat Ire of Contractor Li arise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF soul woe .
COUNTY OF semi wde
The for ing ins ument was acknowledged before me
�iday
The fo ng instr ent was acknowledge efore me
this ofJXe',eln �r . 20� 6y
this ay of Cr 201& by
Michael J Newman
Michael J Newman
Name of perso9 making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Iden[if ion
Type of Ideritific on
P oduced
Produced
(Sign ure of Notary ublic-
of Notary Public -State of Floridallotary
Public State of Florida
r
Commission No. Gc221a3a IBacaene Newman
latu
mission No. GG221a3a //����''��
n kialic State of Florida
y Commission GG 221434
05/23/2022
Francene Newman
„FyF
+� •Expires
My Commission GG 221434
4i of Expires 05123/2022
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Rev.8/2/17 1 IY