HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l J�[�f�
Date: o / Permit Number: / � ��0 r T
RECEIVED
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: To Select from dropbox, click arrow at the end of line Screen
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PROPOSED IMPROVEMENT LOCATION:
Address: 50 San Luis Obispo, Fort Pierce
Legal Description: Spanish _ bakes CCV Leasehold Estates Lot 50
Property Tax ID#: 1301-500-0977-000/1 Lot No.50
Site Plan Name: Spanish Lakes Country Club Village Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Screen rear lanai under existing truss roof, on existing
slab. (101x201 )
CONSTRUCTION INFORMATION:
Additional wor to be ertormed under this permit—check a appy:
HVAC Gas Tank F]Gas Piping �Shutters Q 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: F]Sewer F—]Septic Building Height:
OWNER/LESSEE: ..:,
.: CONTRACTOR:
Name Tom Zachareas Name: Jeff Jackman
Address: 50 San Luis Obispo Company: Master Craft Aluminum Prod.
City: 'Fort Pierce State: FL Address: 1634 Se Niemeyer Cir.
Zip Code: 34951 Fax: City: Port St. Lucie State: FL
Phone No. 882-6070 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: ma Gt-Prr-ra f to 1 ii m i ni-im(lgma i 1 -ram
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.
CONSTRUCTION LIEN LAW INFORMATION:
15E ICtNER/ENGINEER: Not Applicable 'MORTGAGE COMPANY: Not Applicable
Name, Name:
Address: Address:
City: State:_ City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: 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
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
Si 4,f O ne /Lessee/Agent Sig to f ntractor/License Holder
STLO I A STA F ORIDA
COUSt. Lucie COU St. Lucie
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 12 day of July 20 16by this 12 day of July 120 16 by
Jeff Jackman Jeff Jackman
(Name of person acknowledging) (Name of person acknowledging)
2LO i
(Signature of Notary PublidiState of Florida) (Signature of Notary P blit-State of Florida)
Sheryl D.Mone
Personally Known X llit@klsn Personally F�{ �€""—•--
d Identification
Type of Identification Pr STATE OF FLORIDA Type of I i S�A v�c► 1L
Comrn#FF942382 -+
Commission No. q/15/2020 Commissi Comm#FFS42382 (Seal)
Expires '05/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS