HomeMy WebLinkAboutREVISION - BUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c� C
Date: 5 Permit Number: 5 \d S d1 v
BY
- - Building Permit Application RECEIVED
Planning and Development Services MAY 31 2019
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucieounty, Permitting
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi en I ��
PERMITTYPE: Screen Enclosure
PROPOSED IMPROVEMENT LOCATION:
Address: 8952 Champions Way Port St. Lucie, FL 34986
Property Tax ID #: 3334-501-0057-000-7 Lot No. 43
Site Plan Name: Block No. A
Project Name:
DETAILED DESCRIPTION OF WORK:
�v �I-.ap CA
Form and pour a penmeter 8' X 8" footer with 12" x 12" comers
Build a 17' X 22' Screen room with a screen roof -}a 1 ZU Y l e P ri tV Vr dVt
I CONSTRUCTION INFORMATION: ..,. ra Ta !fie_ L I
Additional work to be performed under this permit —check all
_Mechanical _Gas Tank _Gas Piping
_ Electric _ Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 17,500.00
Sq. Ft.
Utilities: _Sewer _Septic Building Height:
6
OWNER/LESSEE:
CONTRACTOR.
NameCesar Cotto
Name: David F Miller
Address: 8952 Champions WAY
Company: A Quality Construction, LLC
City: Port St. Lucie State:E- -
Zip Code: 34986 Fax:
Phone No.917-584-4752
Address: 3531 S 25th S 25th St
City: Fort Pierce State: FL
Zip Code: 34981 Fax: 461-3038
Phone No 772-343-0805
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail AQuality0l@bellsouth.net
State or County License CBC1257739
it value or construction is SZ500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: RA Dunlea
MORTGAGE COMPANY: �( Not Applicable
Name: 7`
Address: 1513 Cervantes Place
Address:
City: The villages State: FL
Zip: 32159 Phone 772-285-64ga
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 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 COMMENVAIEMT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEW TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE F COMMENCEMENT."
Signatur f Owner essee/Contractor as Agent for Owner
Signature o ntractor/License Holder
STATE OF FLORRIDA
STAT OF FI OR�DA
COUNTY OF 'S�( , ll-v c `.
COUNTY OF LUc \�
The forgoing instrument was acknowledge before me
\ day y'�0.'�� 11
Theforgoing instrument was acknowledged before me
W\ 2.:
of, 20 by
thist�3
this day of . 20 117 by
\)d')�. k " " \ f
io)M!\\VtC
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identific@}on
Produced \ 1-
Type of Identifccation n L
Produced
(Signature of Notary Publi State of Florida)
Commission No. 6"�.�Atl E NS
(�N"dt]Mtd15610N6GG 02203C
Ignature o blic- ste'>D'PN04I8dIyENs
'f MY COMMISSION A Guu' 022023 �r,
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mission ;; }
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OFFICE USE ONLY:
DATE FILED:
REVISION FEE: rm•' V
LOCATION/SITE
ADDRESS:
PERMIT#-lQs•Q��
RECEIPT #
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982.5652
(772)462.1553
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION
DETAILED DESCRIPTION OF PROJECT
REVISIONS:
CONTRACTOR INFORMATION:
STATE of FL REG./CERT. #: C_CSL I S�
BUSINESS NAME: A
QUALIFIERS NAME: �0.0C_ M : \\+ c
ADDRESS: ZC"zv C . 2cT� S1_
CITY:
STATE:
PHONE (DAYTIME): -h - -cl, I -y D ob
OWNER/BUILDER INFORMATION:
SCABNYNED
St. Lucie County
ST. LUCIE CO.CERT. #:
ZIP: 29 K 1
FAX: 772-90A 639
NAME: L ecc,- C.o'kko
ADDRESS:
CITY: P•,Ac STATE: r-L-
PHONE (DAYTIME:_ FAX:
ARCHITECT/ENGINEER INFORMATION:
ZIP: 349 i L
NAME: I
•.. _ � r
ADDRESS: 5q%A . u
CITY: ST-ATE: ZIP:
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Revised 0613
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REVI""
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Sheet 2 of 3 (Sketch of Survey). See Sheet 3 of 3 for Legal Description, CeNRcallons, Property and other Survey related data. SURVEY IS NOT COMPLETE WITHOUT
BEARING REFERENCE:
NORTH LINE OF SUBJECT LOT AS N. 81'38'00" E.
ALL BEARINGS SHOWN HEREON REFERENCED THERETO.
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Office: (561) 367-3587 Fax: (561) 465-3145 ormBy: IL600SSELOT 3 �, S U Ry E Y I; N G
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