HomeMy WebLinkAboutPermit AppALLAPPLICABLEINFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
s
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
D nnnc.l=n tmPRnV.Fr%AFNT LOCATION
Address: 7301 Santa Rosa Parkway, Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK -UNIT 4- BLK 38 LOT7 (MAP 13111 N) (OR 3352-1
Property Tax ID #: 1301-604-0199-004-2
Site Plan Name:
Project Name: ____
Setbacks Front
Back: Right Side: Left Side:
Lot No.
Block No.
I DETAILED DESCRIPTION OF WORK: I
Tear off shingle roof install new shingle roof on a 6112 pitch
OC FL # 10674-R12 with peel and stick FL # 16048-R3
CONSTRUCTION INFORMATION:
Additionatwor to e e orme un er this permit— check all that apply:
HVAC 0 Gas Tank OGas Piping _ Shutters Q Windows/Doors
Electric E Plumbing ❑ Sprinklers Generator . Roof
Total Sq. Ft of Construction: 2600 SQ. Ft. of First Floor:
Cost of Construction: $ 7990 Utilities: 0 Sewer Septic Building Height:
3WNER.LESSC)PiIT��t
Name Keith Taig
Arldrpss: 7301 Santa Rosa Parkway
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No.
E -Mail:
Fill in fee simple Title Halder on next page (if different
from the Owner listed above)
Nam,.: Richard A. Newland
Company: Richie the Roofer
Address: 6704 Santa Clara Blvd
Cit -v: Fort Pierce
Zip Code: 34951 Fax:
Phone No. 772-473-6197
E -Mail: richieroofer@yahoo.com
State or County License:
If value of construction is $2504 or more, a RECORDED Notice of Commencement is required.
State: FI
SUPPLEMENTAL CONSTRUCTION LIEN LAZA/ INFORMATION: -
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip:
Phone:
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: _
Address:
City:_
Zip:
certify that no work or installation has commenced prior to the issuance of a permit.
Phone:
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 1 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 ST Lucie
re of Contractor/License Holder
STATE OF FLORIDA
CO U NTY OF St Lucie
The fo Ding instrument was acknowledged before me The forgoing instrumme�ntt was acknowledged before me
this ay of C 20 by this day of C /� ~ 20 by
(,'tom✓ �' �it�,✓ � .t 2G r -►'c' /'�--t,�..
(Name of person acknowledging) (Name of person acknowledging )
oLt,�'
/_L //
04'v�_
(Signature of Notary Public- State of Florid ) (Signature of Notary Pub ie- State of Florida
Pers o nown OR Produced Identificationrmi TI y Know OR Produced Identification
Type o ratification Pro ratification Produced
;.S,,?y'CH I MARIE RODRIGUE$ !Commission No ' My�ISS10N#GG 152o4Uion No.1,�,6C; yp RISTINAMARIEROD
*:..4.
y, ro EXPIRES: October 16, 2421 *: . �: MY COMMISSION # GG
Revised 07/15/2014 '�� PF F , $onCed Thru Notary Public U
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS