HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �J
Date: 10/18/17 Permit Number:
Building Permit Application
Planning and Development Services OCT 17 2017
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: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 0 7 Dr+ 550
Legal Description: SAVANNA CLUB PLAT THREE BLK 27 LOT 6 (OR 708-1220; 3761-2657)
Property Tax ID#: 3425-703-0274-000-3 Lot No.6
Site Plan Name: Block No. 27
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW SHINGLE ROOF (MOBILE HOME)
CONSTRUCTION INFORMATION:
Additional work toe nertormed under this permit-check all appy:
E]HVAC Gas Tank []Gas Piping Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof 312 Roof pitch
Total Sq. Ft of Construction: 1980 S . Ft. of First Floor:
Cost of Construction:$ 7500 Utilities:cn Sewer Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name ko6er-� Me-Coo der (I2�) (E5fi) Name: O-r
Address: l %ana-hAxe 2d Company:;(tel1 fY P.D.gprx Aw
City: M6bdla�r 5e2-tlt State:_JAR Address:��ZIt JAS �( q
Zip Code: 64-7 3q Fax: City: 'a- R ei-C-e- State:
Phone No. le / -7- 7 fSS- S L109 Zip Code: '-�(4q$g' Fax: -1-)a-UkQ1A-hkD
E-Mail: Phone No. 1_7__1-' CA Lu_LQW0
Fill in fee simple Title Holder on next page(if different E-Mail: 1 1 n► �cL11arPq r� s' ouL�
from the Owner listed above) State o nty License: CCC1326177
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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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 thepermit 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.
/1X-a' 16 ZJ" r
Sign a of Owner/Lessee/Contractor as Agent for Owner Sign re of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 18 day of OCTOBER 201-7 by this 18 day of OCTOBER 20 0 by
CHARLES RICHARDS CHARLES RICHARDS
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produced Produced
� c
nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
00•Aub'*eal) FAITH MASON Commission No. °�;:��P:'�� F � 1SON
Commission No. � •'•''• `� MYC "�(
OMMISSION#GG 00393 * COM ISSIO #GG OD3939
EXPIRES:June 20,2020 �^ c� EXPIRES:June 20,2020
rFOF FLOP`°! Bonded ThN Bud et 9rff OQ� Bonded Ttuu Mait Notari SGryiwe
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17