HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: la 1 1 I ,ry Permit Number:
RUM'-D DEC 192016
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Building Permit Application
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: Shutter
PROPOSED IMPROVEMENT LOCATION F01
Address: 5 Verde Vista,Ft Pierce, FI 34951
Legal Description: Spanish Lakes Country Club Village Leasehold Estates(OR 2389-639)That Part of SEE As
Shown in Or 2389-639 Being Lot 5 Verde Vista(0.14 AC-6,098 SF)(OR 3864-759)
Property Tax ID#: 1301-500-1126-000-8 Lot No.
Site Plan Name: 5 Verde vista Block No.
Project Name:
Setbacks Front ;x.Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
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L7n5 14 llr� 10 G GG(lr� do S blu 1 "try oti. �ll a V1 v T�►(�C W i U �AG�oSP. INC- .Lu rw
CONSTRUCTION INFORMATION `"
Additional work to beMnertormed under this permit—check all that appy:
❑HVAC Gas Tank Gas Piping Shutters 0 Windows/Doors
Electric ❑ Plumbing Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 5200.00 Utilities:oSewer Septic Building Height:
OWNER%LESSEE r : CONTRACTOR
Name Ronald&Nancy Breberg Name: Jeff Jackman
Address:5 Verde Vista Company: Master Craft Aluminum Products
City: Ft Pierce State:_ Address: 1634 SE Niemeyer Cir
Zip Code: 34951 Fax: City: Port St Lucie State:fl
Phone No.651-225-0922 Zip Code: 34952 Fax: 772-335-0860
E-Mail: Phone No. 772-335-1177
Fill in fee simple Title Holder on next page (if different E-Mail: mastercraftaluminum@gmail.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.
SUPPLEMENTAL CONSTRUCTION,LIEN LAW INFORMATIVON
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY X 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.
1�w N,-A.- )V X�_
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Sig=ureOerLess Contractor as Agent for Owner Sig ture n actor icense Holder
STRIDA STA F RIDA
COUNTY0FStLucie COUNT St Lucie
The forgoing instrumeAt was acknowledged before me The forgoing instrument was acknowledged before me
this Iq day of 204-t by this J_L day of20 J(o by
(Name of person acknowledging) (Name of person acknowledging)
�4� =!41//0
(Signature of Notary Public-Mate of Florida) (Signature of'Notary Pu lic-State of Florida)
Personally Known OR Produ ed Idi Personally Known _OR Produced Identification
Type of Identification ProducedUC— Type of Identification Prod d
Commission No. f SAI E OF FLORIDA NOTARPU�LIC
FF942382 Commission No. STAB }} MDA
• Explres 1/1512020 Carta#FF942382
Exphn 111512020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW_ REVIEW
DATE
COMPLETE
INITIALS