HomeMy WebLinkAboutBUILDING PERMIT APPLICATION,V � 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: GU • '_Z!%q Permit Number:
Building Permit Ap
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
-0477.
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PERMIT APPLICATION FOR: Aluminum without concrete III
PROPOSED
Address: 5510 Killarney Ave Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK- UNIT 12- BLK 157- LOTS
Property Tax ID #: 1301-614-0025-000-3
26 AND 27
Site Plan Name: Bryant
Project Name: Bryant
Setbacks Front 117A Back: 34 Right 14.Qr g Left Side: N%A
Lot No. 25,26,27
Block No. 157
DETAILED DESCRIPTION OF WORK: III
Install a 32' x 11' aluminum/screen enclosure with poly roof on existing concrete.
CONSTRUCTION INFORMATION:
Aaditional work to tielentormed under
tispermit—check
all apply:
�HVAC Gas Tank
❑Gas Piping
_Shutters
Windows/Doors
Electric 0 Plumbing
Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 6,990.00
Utilities:n
Sewer E]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Nancy C Bryant
Name: Michael J Newman
Address:5510 Killarney Ave
Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No. 772461-6263
Address: 1682 SW Biltmore St
City: Port St Lucie State: FL
Zip Code: 34984 Fax: 772-340-4626
-Phone PYo�-�2-340-4393
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 $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTR.UCTION:LIENjLAUU INFORMATION"
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DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable ^
Name: oo 1Gm a Assocates
Name:
_
Address: Po Box1oD39
Address:
City: Tampa State: FL
City:
State:
Zip;.33679 Phonealaasr-ssss —
Zip: --Phone:
FEE SIMPLE TITLE HOLDER: ✓ Not Applicable
BONDING COMPANY:
12Not 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 o your property. A Notice of Commencement must be recorded and sted on the jobsite'
before the fi inspection. you intend to obtain financing, consultyt lender or p�attorney before
co�nci work or rec�,rdina vour Notice of Commencement. / / �
r
�Slgna re of Own / Less /Contractor as Agent for Owner
Signa re of Cont ctor icense Holder
STA E OF FLORIDA
STATE OF FLORIDA
COUNTY OF saint wee -
COUNTY OFs> mwde
The for gg�o�ing instrument was acknowledged before me
this�'r`~dayof FJo/„ o" .20_0by
The for€oing instrument was acknowledged before me
this I't'tdayof 20(9 by
Michael J Newman
Michael J Newman
Name of persoq making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of identification
Type of Ideritificatio
Produced
Produced
(Signature of botary Public-S to of Florida)
-(Signatur of Notary Public- t f I r
Commission No. GG221434 .N*�(SBel�ry Public State of Flo
�'CG ission NO. GG2214.94 � Noie�q� Public Stale of Florid
(��tlene Newman
Francene Newman
q My Commission GG 2214
Ex Commission 22 2214 31
Expires O6r1312022
ha AoF Expires 0512312022
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REVIEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
— - -
- - - -
RECEIVED
DATE
COMPLETED
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Rev. 8/2/17