HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date: ���a1�,1 Permit Number:
4 Ig C �
Building Permit Application
Planning and Development Services
Building and Code Regulation Division BY:. .......................
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof - S \ 'V\ �t
PROPOSED IMPROVEMENT LOCATION:
Address: 6707 Woodsmere Way Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 7-BLK 86 LOT14 (MAP 13/02N)(OR 566-841)
Property Tax ID#: 1301-607-0372-000-8 Lot No. 14
Site Plan Name: Block No. 86
Project Name: Cox
Setbacks Front_ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove entire 19sq of existing roof shingles system. Install new GAF Timberline Dimensional Shingle
with new flashing, boots, jacks and pipe vents.
[CONSTRUCTION INFORMATION:
Additional wor to be performed un er t °spermit–c ec all that appy:
HVAC Gas Tank ❑Gas Piping 1:1_Shutters Q Windows/Doors
1-1 Electric 0 Plumbing ❑Sprinklers 11 Generator Roof 4/12 Roof pitch
Total Sq. Ft of Construction: 19sgs S . Ft.of First Floor:
Cost of Construction:$ 9,854.95 Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name David K Cox &Shelva J Cox Name: Crystal Anderson
Address: 6707 Woodsmere Way Company: Olneya Restoration Group, LLC.
City: Ft. Pierce State: FL Address: 4253 SW High Meadow Avenue
Zip Code: 34951 Fax: City: Palm City State: FL
Phone No. 772-359-2791 Zip Code: 34990 Fax: 772-925-8417
E-Mail: d.k.cox@fpl.com Phone No. 772-222-5019
Fill in fee simple Title Holder on next page(if different E-Mail: llawrence@olneya.Com
from the Owner listed above) State or County License: CCC1330974
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: __),L 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 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 our Notice of Commencement.
Signature ot dwner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLOR STATE OF FLORI
COUNTY OF "aQ I!1 COUNTY OF WQAl1i
Thergoing instrumt was acknowledged before me The forgoing instr_yTQ�en�t was acknowledged before me
this day of e 20 k1 by this day of N ryW 20by
Name of person making statement Name of person making statement
Personally Known_OR Produced Identification Personally Known )( OR Produced Identification
Type of Identification Type of Identification
Produced Produced
_1�() &I k Lu ELL, -M'dn I Aa'c
(Signatu of Notary Public-State of Flo 'd of Notary Public-State of Florida )
"'�""^•
MEGAN JEANET't LAWRENCE Y'p' EGANJEANETTELAWRE C
Commission No. �U ag1 0) .t Notaryhblic atEf0widissl n NoC�Ob 4Z� t'� I
• ' Committio�M G 097477 ? Co Public-State of Fl id
My Comm,Expire Apr 24.2021 i' '€ CommissionasA x247
Jw*d Mwu�M oil Natxy Attr. R ' My Comm.Expires Apr 24, 2
Bwded ti,rou&Natioral Nota ss
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17