HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAW4-INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t
Date: �U( Permit Number: V
RECEOVED
S �
Building Permit Application AUG -8. 2016
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: dropbox,To Select from dro box, click arrow at the end of line Infill
PROPOSED IMPROVEMENT LOCATION: -
Address: 6500 Teresita Court Fort Pierce FL 34951
Legal Description:Spanish Lakes Fairways Leasehold Estates Block 59 Lot 18
Property Tax ID#:1306-501-0699-000/6 Lot No.
Site Plan Name: Spanish Lakes Fairways Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: Enclose lanai under truss roof on
existing concrete With screen. (10 'x20 ' )
CONSTRUCTION INFORMATION:. .
Add itional work to be nertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: 200 Sq. Ft.of First Floor:
Cost of Construction:$ 2, 000. 00 Utilities: Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:'
Name Boris & Gannetta Gi 1 aur Name: Jeff Jackman
Address: 6500 Teresita Ct. Company:Master Craft Aluminum Producti.
City: Fort Pierce State: FL Address:1634 SE Niemeyer Circle
Zip Code: 34951 Fax: City: Port St. Lucie StateFL
Phone No. 973-219-6344 Zip Code: 34952 Fax: 335-0860
E-Mail: Phone No. 335-1177
Fill in fee;simple Title Holder on next page (if different E-Mail:mastercraf taluminum@mail.com
from the Owner listed above) State or County License: SCC131150586
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. dr
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: /Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
i
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _/Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Cobnty 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
s
_SigoNi
ner Lessee/Agent Signa. re opt o er
STAD STAT DA
COOSt. Lucie COON St. Lucie
I
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 15day of July 20 16 by this 15day of July 20 16 by
! Jeff Jackman Jeff Jackman
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pdlie of Florida) (Signature of NotaryPublic-State of Florida)
Personally Known X OR Produced Identif. icg16 Personally Known X OR Produced Identification
Type of Identification Produced sType of Identification Prod��D.Moore
PAT M- BuieNOTARY pUBI.
Commission No. ( TATE OF FLORIDA Commission N OF FLO (Seal)
Comm FF942382 Comm FFW,
F_xplres 111512020 :,
Revised 07/15/2014
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