HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,(�C/ SCANNED Permit Number: O
rs -�' ` BY =RECEIVED• St. Lucie CountyBuilding Permit ApplicationPlanning and Development ServicesBuilding and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Aluminum with®concrete III
PROPOSED IMPROVEMENT LOCATION:
Address: 117 Queens Rd Hutchinson Island, FL 34949
Legal Description: QUEENS COVE- UNIT THREE- BLK 25- LOT 4
Property Tax ID #: 1423-602-0004-000-8
Site Plan Name: Thomas
Project Name: Thomas
Setbacks Front N/A Back: 31' Right Side: 2b1 Left Side: 18.88
DETAILED DESCRIPTION OF WORK:
Lot No.4
Block No. 25
Form and pour 12" x 12" footers and install a 10' x 22' aluminum/screen enclosure with poly roof.
CONSTRUCTION INFORMATION: III
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HVAC _ Gas Tank ❑Gas Piping
Electric 0 Plumbing ❑Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 5,950.00
Shutters ❑Windows/Doors
Generator Roof = Roof pitch
Sq��Ft.I of First Floor:
Utilities: nSewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Lorenza'and Jonathan Thomas
Name: Michael J Newman
Address:117 Queens Rd
Company: Pioneer Screen Co. Inc. II
City: Hutchinson Island State: FL
Zip Code: 3499��4911 Fax:
Phone No. 11 T �t "1— gt{(ps
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: rens928@yahoo.com
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL='CONSTRUCTION"`LfEN<LAiN,INF`ORMATION;
5... 'r._... .._l`-
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-
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: _
Not Applicable
Name:Do Kim &Associates
Name:
Address: Po eox 10030
Address:
City: Tampa
State: FL
City:
State:
Zip- 3357e Phone813-W-9955
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _
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
improvement to your property. Notice of Commencement must be recorded and posted on the jobsite'
before the f t inspection. If yo ' tend to obtain financing, consult wit ender or an att ey before
' w commen ork or recordin our Notice of Commencement.
i
Sign ure of Owner/ ssee/Contr for as Agent for Owner
Signature o Contractor/L' ense lolder
STATE OF FLORIDA
STATE OF FLORIDA 0s
COUNTY OF saet w=e .
COUNTY OF stint Lx=a 2
A
off,.
The forgoing instrurpent was acknowledged}�efore me
The for oing instru e t was acknowledged before me
this day of NLCi /G� 20�`( by
this day of C�\ 20,� by a ;
Michael J Newman
H $
Michael J Newman
Name of perso9 making statement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known ✓ OR Produced Identification 3
"' ct
Type of Identificati
Type of Ideritificati Y
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Produced
N
Produced
'a
(Signature f Notary Public- Stature
f Notary Public-S ,
t,6��Notary Public State of F
Ada g.�*�1y, Notary Puma, r FloridCommission
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No. cG2zt43a alltrancene Newman
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17