HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9-14-2017 Permit Number:
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Building Permit Application
Planning and Development Services
Building and Cade 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: 5412 Echo Pines Circle
Legal Description: HOLIDAY PINES S/D-PHASE I-LOT 115(MAP 13/12S) (OR 3752-1503)
Property Tax ID#: 1312-500-0116-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tear off existing shingle roof and install shingle roof Fl 10674-R12 and Peel and stick I=L16048-R3
on a 6/12 roof pitch
CONSTRUCTION INFORMATION:
Additional work to be nertormed un er t is permit-check a11 apply:
�IHVAC Gas Tank F]Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers O Generator Roof
Total Sq. Ft of Construction: 4200 S Ft. of First Floor:
Cost of Construction: $ 16470 Utilities:0 Sewer F�Septic Building Height: 15'
OWN ER/LESSEE: CONTRACTOR:
Name Kenneth Blackman Name: Richard A. Newland
Address.5412 Echo Pines Circle Company: Richie the Roofer
City: Fort Pierce State:FL Address: 905 13th st sw
Zip Code: 34951 Fax: City: Vero Beach State:FL
Phone No.772-216-5125 Zip Code: 32962 Fax: 566-610-8652
E-Mail Phone No. 772-464-4329
Fill in fee simple title Molder on next page (if different E-Mail: richieroofer@yahoo.com
from the Owner listed above) State or County License: CGC 1512738
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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. RichardANewland Name:
Address: god 13th st sw Address:
City: Vero Beach City:
Zip, 32962 Phone,• 772-473-6197 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 our Notice of Commencement.
_Signature of Owner/Lessee/Agent ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF j i✓. COUNTY OF ,���.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this '`day of „a.,.�y � r 20 .L,by thisdayof ,��,'�,�„ f,, r 20 t'7 by
(Name of person acknowledging) (Name of person acknowledging)
C L', - I L
;4
(Signature of Notary Public-State of flarida} (Signature of Notary Public-State of Flo Ada}
Personalty Known OR Produced Identification��.� Personally Known OR Produced ldpntificarinn ylr
Type of Identification Produced ( Type of Identification Produced
Commission No. ;` ..,YP CHRIS7 A lirRQOR{CUES Commission No. "'r?" C} BgdMARIERODRIGUES
CO� QN#GG 15204 :+'' �`: MY COMMISSION#GG 152040
EXPIRES:October 16,2021 '�-
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Revised 07/15/2014 -Rk",Botidid Thru Notary P.M.Undarwritera
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS