HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONti
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (("�� !r,
Date: Permit Number: _ t, bra—' 65�J
�• - RECF,fyED
Building Permit Application —Ffe 2 to
Planning and Development Services Permitting oe
Building and Code Regulation Division St, Lucie courrTm
2300 Virginia Avenue, Fort Pierce FL 34982
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Phone: (772) 462-1S53 Fax: (772) 462-1578 -Commercial Residential x SCANNED
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line St. Lucie Coul
FROPOSED IMPROVEMENT LOCATION. _ ii -
Address: 2999 Conifer Dr Ft Pierce Fl, 34951
Legal Description: Monte Carlo Country Club unit one Lot 184 (or 4057-1911)
Property Tax ID #: 13727-801-0073-000-8
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No. 184
Block No.
Install a Screen Enclosure
IRI-r ni sly _� 1-nsA,&,k l pa" e-r s S+D ne-S +0 m a_"- ex l s{ r' j 11
13tea1e� Screen w0.�1 toi4an a moLr�Sc&rcA �1iclr eol SCf2¢•n fab�l e iS-6nc� Slab
CONSTRUCTION INFORMATION:
u
JHVAC LJGas Tank
11 Electric Plumbing
Total Sq. Ft of Construction:
Cast of Construction: a 12,960.00
Piping LJ Shutters
nklers Generator
Sq. Ft. of First Floor:
Utilities: nLJSewef Septic
❑ Windows/Doors
0 Roof = Roof pitch
Building Height: 15
OWNER/LESSEE: ,= , ..
..,
`CONTRACTOR:
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41--'4.-,,..•^:_:--.aw •,:..Kr.
Name Rafiael Vias `. '
,.... .• _.fie... ..a-. „..... c _;,.:...
Na§teve Mears, "` g
Name--
Address: 2999' Conifer Dr. .•
Company ,`Lifetime Eztenors 1' p.
City s Ft Pierce? • , , • State F�
�•
Zip Code:.34931.,r:;, ; :...fax:.:>vnf.
Phone No.
Address:''102 South F St `•
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City:- State: FI—
Zip Code: 33460 Fax: 561-582-7505
Phone No.-561-533-8700- - —, --- - -
E-Mail: - -- --- - - -
Fill in fee simple Title Holder an next page (if different
from the Owner listed above)
E-Mail: Diane@Lifetimeexteriors.net
State or County License: PSL13-593
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
a
Name: — --
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: — Not Applicable
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable I BONDING COMPANY: _Not Applicable
Name:
Address: 102 South F St
City:
Zip:- Phone:
Address:
Zip:
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.
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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 on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
S gnature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Ponstwaa
COUNTY OF P-n& Wda
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of�_ 201a by
this,9,fo day of. FtjoM
art i . 201q by
QPLQAP 1 V
rV ewt
ss
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification x
Personally Known x
OR Produced Identification
,Type of Identification
Type of Identification
Produced oL A
Produced
Sig toe of Notary ubhc--State f Florida)
'(SigNatuile of Notary Public-
Statof Florida )
Commission No. r"JiY� "••.,• 06EIl. D. BERMSEN
Commission No.
KRYST 6�- RNTSEN
s i Notary PUbifc -State of Flodda
otary Public • State of Florida
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Commission g GG 269a5a
'�?ar My Comm. Expires Oct 27, 2022
Commisston r GG 2a965a
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onded throughono
otary Assn.
Bonded through Natlo
1 Notary Assn.
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DATE
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DATE
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COMPLETED
Rev.8/2/17