HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: REC
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Building Permit Application OCT 2 9 2015
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 Residential X
PERMIT APPLICATION FOR: Aluminum without concrete
PROPOSED.,LMPROUEMENT4JLOCATI,ON
Address: 9524 Shadow Lane Fort Pierce, FL 34951
Legal Description: Monte Carlo Country Club-Unit 2-Lot 231
Property Tax ID#: 1334-502-0112-000-8 Lot No.231
Site Plan Name: Wilk Residence Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK -
FILL IN PERMIT- Install screen panels on slab and under covered porch 28'x 13'
CONSTRUCTION INFORMATION
Additional work toe e orme under t —checkispermit a appy:
HVAC E]Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ A ��D/rD i?t2 Utilities:n Sewer[]Septic Building Height:
1
QWN ER%LESSEE. _"CO NTRACT, 0
Name James&Susan Wilk Name: Michael J Newman
Address:9524 Shadow Lane Company: Pioneer Screen Co. Inc. II
City: Fort Pierce State:FL Address: 1682 SW Biltmore St
Zip Code: 34951 Fax: City: Port Saint Lucie State:FL
Phone No.734.915.0788 Zip Code: 34984 Fax: 772.340.4393
E-Mail: Phone No. 772.340.4393
Fill in fee simple Title Holder on next page(if different E-Mail: Pioneerscreen@msn.com
from the Owner listed above) State or County License: RX11066919
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPP'k.EIVIENTAL CONSTRUCl'ION,LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: �/ Not Applicable
Name: D b K m M 50 U a+e,5 Name:
Address: fo. ibv 1 D d,6c' Address:
City: —'ra.r•t-\ PA State: L- City: State:
Zip: "6�;L- q Phone: c8 13. 5 1.G C1 55 Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: v/ Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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
WARNINGTO NER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvemen your property Notice of Commencement must be r rded and ed on the jobsite
before the r inspection. If y u ntend to obtain financing, consult lender or n orney before
com c' work or recordi our Notice of Commencement.
s
_Sign ure of Owne Lessee/ gent Signat re of Contra or L(St
ens Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF L t�Ct COUNTY OF . U,6-e-
Thef May
instrumentwas acknowledged before me The forgoing instrument was acknowledged before me
this May of QCA-V bey- , 20 15 by this as day of 20 %6 by
�A � tAG c l :T �ea,�rr�a n h i t ha e-1 -s 4 eL,)Y -•g-r%
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Nota ublic-.State of Florida) (Signature of NotaW Public-State o Florida)
Personally Known �OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
,c D
Commission No. ��� `, LyG;l�,��• B Ll+S WALLA mmission No. 16��LY
I: !fir 'WALLACE
My COMMISSION#EE8302 0 `` .�.+ "e M G
EXPIRES November 03,2016
EXPIRES November 03,2016 ' ?qq�,
Revised 07/15/2014 ll0fl'1£tf1'016a FlondallotarySernce.com I l40?).!1iM-0193 FlaadallotarySemce.com
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