HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
S``„NIMED Permit Number: L%
BY RECEIVED
St. Lucie Goa* JUN 18 2019
Building Permit Application Permitting Department
St. Lucie County
Commercial Residential xxxxxxxx
PERMIT TYPE:
PROPOSED IMPROVEM) NTICICATION:
Address: 12069 South Indian River Drive
Property Tax ID #: 4504-602-0009-000-0
Site Plan Name: Michael Farrell
Project Name: Farrell Residence
Installation of Concrete and Installation of Pool Screen Enclosure
Additional work to be performed under this permit— check all that apply
Lot No.10
Block No.
_Mechanical _ Gas Tank
_ Gas Piping
_ Shutters
_ Windows/Doors
Electric _ Plumbing
_ Sprinklers
_ Generator
_ Roof Pitch
Total Sq. Ft of Construction: I 1�4-7
Sq.
Ft. of First Floor:
/�
JJ4CJ.
Cost of Construction- $ (J
Utilities:
_Sewer _Septic
Building Height:
.OWNERAESSEE. � - s-
NTRACTOR:',
Name Michael Farrell
Name: Craig Rice
Address:12069 South Indian River Drive
Company: Pioneer Screen LLC
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.
Address:3290 SE Slater Street
City: Stuart State: FL
Zip Code: 34997 Fax: 772-283-3028
Phone No772-283-9197
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Bev@pioneerscreen.com
State or County LicenseSCC046064
It value of construction is 52500 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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFQRMATION
�= f.
DESIGNER/ENGINEER:
Name:
_Not Applicable
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING.YOUR NOTICE OF COMMENCEMENT"
d L// a
as Agent for Owner
STATE OF FLQt;IpA STATE OF FLO —
COUNTY OF � � n COUNTY OF
The for ing ins en t was acknowledged before me
this vdayo A�20-4by
01 WS: .CP
Name of on making statement.
Personally Known OR Produced Identification
Type of Identification
Holder
The for,�o,}}',,ng insty�ryent was acknowledged before me
this[71 yof�(204 by
C1�.IQf Q �LQF
Name of pen making statement
Personally Known _J:!�'OR Produced Identification
Type of Identification
Produced
�V&aeal
(Signature of Notary Public- State of Florida]
,iyZd1C^.¢g'¢� BE�I jHADDAD
Commission No. MYCSi135I0N#GG 009363 Commission No.
o EXPIRES: July 6, 2020
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EXPIRES: Jul% 6. :
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MY COMMISSION k GG 009363
EXPIRES: July 6, 2020
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