HomeMy WebLinkAboutBUILDING PERMIT APPLICATION{ • 1
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a aG Permit Number:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
RECEIVED
Building Permit Applica[ion FEB 2 22019ucie County, permitting
Commercial Residential X
PERMITTYPE:
.PROPOSED IMPROVEMENT LOCATION.
Address: 3022 nw radcliffe way
Property Tax ID #: 4426-703-0012-000-2 Lot No. PlmbeAd L""
Site Plan Name: Block No.
Project Name:
DETAILED•DESCRIPTION'OF WORK:, .
Building Screen Enclosure over the pool S CAN N F n
BY
CONSTRUCTION INFORMATION; ;- ,'•
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $21ft .
_ Generator
Sq. Ft. of First Floor:
Windows/Doors
_ Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER%LESSEE:
CONTRACTOR:`
Nameozer
Name: Mario Russo
Address:3022 NW Radcliffe Way
Company: Mario Russo Aluminum Inc
City: Palm City State: _
Zip Code: 34990 Fax:
Phone No.561-306-8920
Address:291 SW Duval Ave
City: Port St. Lucie State: FL
Zip Code: 34983 Fax:
Phone N0772-370-8671
E-Mail:
Fill in fee simpleTitle Holder on next page (if different
from the Owner listed above)
E-Mail russocustomfloodng@yahoo.com
State or County License
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7S00 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Fw�a��"�
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: smo�sts�at++0
Address:
City:T-W State: m
Zip:33W9 Phone8+M74-2403
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 Coon ty 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, 1 do hereby agree that 1 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: roam 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE, OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/Licefise Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF J� W
The forgoing instrument was acknowledged before me
The fpJ� ing instruTnt as acknowledged before me
this _ day of . 20_ by
this - day of Ise YW1y . 20-d by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced Y_cOLI
49�
(Signature of Notary Public- State of Florida I
of
gnrisslilonNo.
105E TAPIA
Commission No. (Seal)
Com
+�; Notary Public-SJggy(rFlorida
W��PPff!----Eammlsslon k 487
My Comm. Expires May 8, 2022
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Rev.2/7/19 "
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