HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE
Date:
TED FOR APPLICATION TO BE ACCEPTED
SCANNED Permit Numberlqoz
BY
St. Lucie County
TV
Building Permit Application "C' "'
Planning and Development Services AM I
Building and Cade Regulation Division
7300 Virginia Avenue, Fort Pierce FL 34982 Fiavnittursg
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residentffil==4
PERMIT TYPE: Screen roof only
PROPOSED IMPROVEMENT LOCATION:
Address: 4500 W MIDWAY RD, FT PIERCE, FIL 34981
Property Tax ID #: 3406-501-OD14-500-9
Site Plan Name: ADULT STABILIZATION UNIT
Project Name: ASU
DETAILED DESCRIPTION OF WORK:
COVER OUT SIDE ACTIVITY AREA WITH A SCREEN ROOF, NO SCREEN WALLS.
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
—Mechanical
Electric
—Gas Tank
— Plumbing
— Gas Piping
— Sprinklers
—Shutters
Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor: —
Cost of Construction: $ 35,000.00
Utilities: —Sewer _Septic
Lot No. 9-12
Block No.
Windows/Doors.
Roof Pitch
Building Height:
OWNERAESSEE:
CONTRACTOR:
NameNEW HORIZONS OF THE TREASURE COAST
Name:JON LEVASSEUR
Address:4500 W MIDWAY RD
Company, EDEN SCREEN & CONSTRUCTION CO., IN
Address: 1997 SE ESTERBROOK ST
—
City: FT PIERCE State:
Zip Code: 34981 Fax:
Phone No. (772) 672-8380
City: PORT ST LUCIE State.FL
Zip Code: 34983 Fax:
Phone N0772-216-6171
E-Mail: [wakefield@nhtcinc.org
Fill In fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail EDEN68@AOL.COM
State or County License CBC 059494
If value of construction Is $2500 or more, a RECORDED Notice of Commencement Is required.
if value of HVAC is $7,S00 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: —NotApplicable
MORTGAGE COMPANY: Z�NotAppricable
Name: Ad V &4 5r_V_06� r_%
Name:
Address:44ol 1 14 e- .1 P-A
Address:
City:Q9_LA-*A 0 0 State: 4�1_
City: State:
Zip4��15Cn Phone .4tpr, +_4 1-4�)M
Zip: Phone:
FEE SIMPLE TITLE HOLDER: NotApplicable
BONDING COMPANY: NotApplicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: _ Phone:
OWNER/ CONTRACTOR AFFIDVTr: 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.LucleCoun makes no representation that is granting a permit will authorize the permit holder to build the subject structure
is in applicable Home Owners Association rules, bylaws or and covenants that may restrict or such
which co 17ict with any prohibit
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 OWNEIE YOUR FAELURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR tMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE J013 SITE THE FIRS I INSPECTION. EF YOU INTEND TO OBTAIN IFINANICING, CONSULT
_WORE
WITH YOUR LENDER ORAN`ATlrORNEY RE RECORDING YOUR NOTICE OF COMMENCEMENT.!
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Signature of Owner/ Lessee/Contract6r as Agent for Owner
e of Contractor/License Holder
STATE OF FLORIDA %
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STATE OF FLORIDA
COUNTY OF � LOCT-C,
COUNTY OF
The forgoing Instrumelt was acknowledged) efore me
this day of It 71 20_B�by
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