HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED
Date:4ftb,WW "�— �� Permit Number:
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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) 462-1.553 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: 5509 Ft Pierce Blvd
Legal Description: LAKEWOOD PARK -UNIT 4- BLK 29 LOT12 (MAP 13/113) (OR 426-2940: 1217-2094; 3761-2667 3806-452)
Property Tax ID #: 1301-604-0054-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
LDETAILED DESCRIPTION OF WORK:
REROOF HOME WITH Owens corning shingle and a Tri built peel and stick on a 4112 roof pitch
C_ 1067
r4 c-, 4L
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit — check all n apply:
HVAC Gas Tank Gas Piping Shutters Windows/Doors
Electric Plumbing Sprinklers
Generator Roof
Total Sq. Ft of Construction: 2590
SFt. of First Floor:
Cost of Construction: $ 10686,50 Utilities:'nSewer 0Septic Building Height: 15'
OWN ERAESSEE:
CONTRACTOR:
Name Susan .i Dudley Nancy E Dudley
Name: Richard A. Newland
Address: 5509 Fort Pierce BLVD
Company: Richie the Roofer
City: Fort Pierce, State: FL
Address: 6704 Santa Clara Blvd
Zip Code: 34951 Fax:
City: Fort Pierce State: FL
Phone No. 480-0859
Zip Code: 34951 Fax: 866-610-8652
E -Mail:
Phone No. 772-464-4329
Fill in fee simple Title Holder on next page ( if different
E -Mail. richierooferOyahoo.com
from the owner listed above)
State or County License: CGC1512738
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:
Name: Name:
Address: Address:
City: State: City:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:
Not Applicable BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit_
Not Applicable
State:
_Not Applicable
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.
gnature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF K F'r
The forgoing instrument was acknowledged before me
this-7day of f _ , c,. _ 20/ by
117
K e C Gtr d / lJ r e—lllo" J'"
(Name of person acknowledging )
//9 r
(Signature df Notary Public- of Florida }
Personally Known OR Produced Identification
Type of Identification Produced
Pi EMSTY 130BU,4
Commission No. a°n I
' IJiI'� ) SSION #[E883,700
I ; 0 &--GES: MAP 13 2047
Revised 07/15/2014
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
COMPLETE
INITIALS
_!"i attire of Contractor/License Holder
STATE OF FLORIDA
COUNTY Of �r
The forgoing instrument was acknowledged before me
this dayof 20 LZ_by
(Name of`person acknowledgingi
6'
(Signature 4 Notary Pu ic- State of Florida )
Personally Known f OR Produced Identification
Type of Identification Producer :aaa a (Ci�i
#il=t
PE883700
x tet` tviY `I: �55�ON ..4
Commission No. I :' j: C411aR 13.20;7
0Banded .:. o l St St to insuance�
SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW