HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -2
Date: 2/15/17 Permit Number: �1 b°Lr � J-111�p
RECER D FEB 17 7317
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce F134982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line RSO
PROPOSED IMPROVEMENT LOCATION:
Address: 7606 SANTA BARBARA DRIVE, FT PIERCE, FL 34951
Legal Description: LAKEWOOD PARK UNIT 1 BLK 5 LOT 2(MAP 13/14N)(OR3145-1)
Property Tax ID#: 1301-601-0048-000-0 Lot No. 2
Site Plan Name: KENNETH SMITH Block No. 5
Project Name: REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
L ��c7' -�cL\&_ o—" -ek I sal Ir't
CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit-check a appy:
HVAC 0 Gas Tank Gas Piping MGenerator
Shutters Q Windows/Doors
11 Electric 0 Plumbing ❑Sprinklers R1 Roof /Z Roof pitch
Total Sq. Ft of Construction: 114 33 S . Ft. of First Floor:
Cost of Construction:$ 5,100.00 Utilities:Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name KENNETH SMITH Name: LEE DINENBERG
Address:7606 SANTA BARBARA DRIVE Company: FREEDOM ROOFERS
City: FT. PIERCE State:FL Address: 5575 US HWY 1,SUITES 1&2
Zip Code: 34951 Fax: City: VERO BEACH State:FL
Phone No. Zip Code: 34967 Fax:
E-Mail: Phone No. 772-318-4600
Fill in fee simple Title Holder on next page(if different E-Mail: 9reatroofs@freedom roofers.com
from the Owner listed above) State or County License: CCC1330900
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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:
FEE SIMPLE TITLE HOLDER: _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 Count 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,W.ork or recording
our Notice of Commencement.
All
_ 1
1 S
Sign re of Owner/Lessee/Contractor s Agent for Owner Signatd're of Contractor/License Holder
STATE OF FLORIDASTATE OF FLORIDA—
COUNTY OF COUNTY OF ,
The for o'ng instr:y=n was acknowledged before me The forgoing instrument was acknowledged before me
this day of � �y�,�, 20 Lby this day of k—[ D-S11. t ,20 by
(Name of p s n acknowledging) (Name of person cknowledging)
T!7 e o Nota ublic-State of Florida) (Sign ture of tary P blic-State of Florida)
Personally Known OR Produced Identification Person Known�OR Produced Identification
Type of Identification Produced Type of Identificatiorf Produced
Commission No. N0yW1!UBUC Commission No. LOR�J��AM9 THIBAULT
STA4E F FLORIDA NOTAR����LIC
Comm#FF036318 ou __
STATE OF FLORIDA
Expires 811 IN IFFOMIC
a Expires 8/10/2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS