HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q _
Date: Permit Number: LO� owl
SCANNElj
• BY
Building Permit ApplicationSt. LucieCount, along ;s
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Planning and Development Services ivaw>Jedao
Building and Code Regulation Division 61QZ j, Ad�
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X �nt3]3ti
PERMIT APPLICATION FOR: Aluminum with concrete
PROPOSED IMPROVEMENT LOCATION:
Address: 8420 Cobblestone Or Fort Pierce, FL 34945
Legal Description: CREEKSIDE PLAT NO. 1 LOT 130
Property Tax ID #: 2326-600-0135-000-4 Lot No.130
Site Plan Name: Roberts Block No.
Project Name: Roberts
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Form and pour concrete slab with 8" x 8" footers and install 26' x 12' aluminum/screen enclosure with
poly roof.
CONSTRUCTION INFORMATION:
❑HVAC
❑ Electric
LJ Gas Tank
❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 9,190.00
Piping ❑ Shutters ❑ Windows/Doors
nklers ❑ Generator ❑ Roof = Roof pitch
S Ft. of First Floor:
Utilities: Sewer❑Septic Building Height:
OW N ERAESSEE:
CONTRACTOR:
Name Danielle and Steven Roberts
Name: Michael J Newman
Address: 8420 Cobblestone Or
Company: Pioneer Screen Co. Inc. II
City: Port St Lucie State: FL
Zip Code: 34945 Fax:
Phone No. 216-7744
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
IT value of Construction is S[Suu or more, a RECORDED Notice of Commencement is required.
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 to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first i ection. If you i nd to obtain financing, consult with lender or an att y before
comme in or recording Notice of Commencement.
Rev.8/2/17
SUPPLEMENTAL CONSTRUCTION. LIEN LAUV INFORMATION
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name: oe Ktm s Asseaalea
Name
Address: Po Box tao39
Address:
City: Tampa State: FL
City:
State:
Zip: 33679 PilOne813-867�955
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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e
Signat a of Contract9 /license older
Signaturet f Owner/ Leg ee/Can ractor as Agent for Owner
STATE FLORIDA
STAT�OF FLORIDA
COUNTY OF sarm was
COUNTY OF sarm i�a
The forgoing instrume t was acknowledged before me
The fo going instrumen was acknowledged before me
this �day of�20,�by
this �dayof C�20ahy
a
Michael J Nevrtnan
Michael J Newman
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 Identificatio
Produced
Produced
(Signaturb of Notary Public-
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of Notary Public- o�onerypublic Stale ofFloridGG227a3a
CommissionNoFtliii�ne
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No. GG221436 GG 221435
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GG 227434
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Expires 65I2312022
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Expires 05/23/2022
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