HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r�
Date: Permit Number: Eli
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Building Permit Applicatio
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
APR 2 3 2019
Permitting Department
_S . L�ugiQ County, FL
PERMIT APPLICATION FOR: Aluminum without concrete SCANNED
PROPOSED IM'ORR0VEMENT.CCitATION.
Address: 5808 Clydesdale Ln Fort Pierce, FL 34987 UU
Legal Description: PONY PINES UNIT ONE BLK A LOT 27
Property Tax ID #: 3309-605-0030-000-3
Site Plan Name: Chapin
Project Name: Chapin
Setbacks Front !J A Back: 160.42 Right Side:
DETAILED, DESCRIPTION ,QF._1NORK , ,
10 ' Left Side: $9 '
Install an aluminum/screen pool enclosure 41'x 28''�onslab bey pool company.
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Lot No. 27
Block No. A
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CONSTRUCTION -INFORMATION - = aMMitinnm1XA1nrVtnhnn=ne nrmaM nn nr t m normit _ r nr e 4 �t enn v
I JHVAC L_IGas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 8,747.00
Piping "Shutters
Ys ElGenerator
S Ft. of First Floor: _
Utilities:11Sewer DSeptic
❑ Windows/Doors
11 Roof = Roof pitch
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ralph and Gabriele Chapin
Name: Michael J Newman
Address: 9101 S Indian River Dr
Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No.772-418-1042
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
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEIVIENTAL,CONSTRUCTIONLIEN
LAW INFORMATION'
DESIGNER/ENGINEER: _
Name: Do let & Associales
Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: Po 13-1oo39
Address:
City: Tampa
Zip: 33679 Phone813.857.9955
State: FL
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFI IVIT: 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 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: 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 t your prope Notice of Commencement must be re rded and posted on the jobsite
before the fir ' spection. If intend to obtain financing, consult witl fender or an aft`Arney before
co enci ork or recor l vour Notice of Commencement: / / //
Signa e,ofOwner Lessee contractor as Agent for Owner
Signatur of Contractoy'cense
older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFsaimuoe
COUNTY OFsmat-ucia
The forgoing instru ent was acknowledged before me
The fo ggo,i�ng mst men
was acknowledged before me
this Jf[ day of= (� 20�by
this �ifday of N,
2613 by
Michael J Newman
WChael J Newman
Name of person making statement
Name of person making statement
Personally Known x OR Produced Identification
Personally Known x
OR Produced Identification
Type of Identification
Type of Identificatio
roduced
sx
Produced
(Sig ture of Notary Public -State orTNotary
I of Notary Public- State of Florida )
ne N State r
Commission No:���a-a.1q3yanceneNewma
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Floritla(yam,publicStale
Commi ion Noa
21434
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' My CommissionGG2214
05/2312022
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Expires 05I23/2022
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MANGROVE
COUNTER
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COMPLETED
Rev. 8/2/17