HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1-28-2017 Permit Number:
71911111MMMM -1-1
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F L O R 1 A A
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION,
Address 8303 Penny Ln
Legal Description: LAKEWOOD PARK -UNIT 8- BILK 93 LOT26 (MAP 13102N) (OR 1780-109)
Property Tax ID ##: 1301-608-0155-000-4
Site Plan Name: Anderson
Project Name:
Setbacks Front Back:
Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REROOF OVER EXISTING ROOF! PER Manufacturers specs mincluded
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CONSTRUCTION INFORMATION.:
Additional work to be ertormed under this permit -check all apply:
11HVAC Gas Tank 0Gas Piping Shutters
11 Electric ❑ Plumbing ❑ Sprinklers Generator
Total Sq. Ft of Construction: 1890 S. of First Floor:
Cost of Construction: $ 5590.00 Utilities:cn Sewer u Septic
OWNER/LESSEE.
Name Paul Anderson
Address: 8303 Penny Ln
City: Fort Pierce, State: FL
Zip Code: 34951 Fax:
Phone No. 772-332-6414
E -Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lot No.
Block No.
OWindows/Doors
Q Roof
Building Height: 9'
f CONTRACTOR;
Name: Richard A. Newland
Company: Richie the Roofer
Address: 6704 Santa Clara Blvd
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 866-610-8652
Phone No. 772-464-4329
E -Mail: richieroofer@yahoo.com
State or County License: 20506
if value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAIN 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 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 your Notice of Commencement.
�- Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me
this day of 20 Lby
(Name of person acknowledging }
(Signature of No4r Pu ic- State of Florida )
rs 11yKnow OR Produced Identification
y ro uce
s
Sig6a of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF �y- L
The forgoing instrument was acknowledged before me
this 24day of 20/7 by
r l��J
(Name df person acknowledging)
(Signature 81'Nota Public- State of Florida )
CZ Personally�Known OR Produced Identification
Type oion_P.rod,
Commission No, 5 Seal iu11�iYB08#L#
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Commission No.
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4v EX iRES: MAR 13, 2017
�� EX'1RES MAR 13, 2017
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE
MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW
REVIEW
DATE
COMPLETE
INITIALS