HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater�1 Permit Number: i] �aJ d� o�
Building Permit Application 11"111 0C
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 x
PERMIT APPLICATION FOR: Roof - 5�� n >Z
PROPOSED IMPROVEMENT LOCATION:
Address: 6708 GADDY STREET FORT PIERCE, FL 34951
Legal Description: LAKEWOOD PARK UNIT 8 BLK 96 LOTS 7 AND 8(MAP 13/02N)(OR 4028-719)
Property Tax ID#: 1301-608-0215-000-3 Lot No.7&8
Site Plan Name: Block No. 96
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE REPLACE W/ NEW SHINGLE
CONSTRUCTION INFORMATION:
Additional workto e er orme under this permit—check a appy:
F_JHVAC Gas Tank []Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof 2 Roof pitch
Total Sq. Ft of Construction: 3252 S . of First Floor: 3252
Cost of Construction: $ 8376.00 Utilities:]Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Na me BLACKWATER TESTING INC.,DENNIS&SANDRA DUFFY Name: DANIELLE BEGGS
Address:9505 LISTOW TERRACE Company: ALLIANCE GROUP
City: BOYNTON BEACH State:FL Address: 532 NW MERCANTILE PL#113
Zip Code: 33472 Fax:772-492-8008 City: PORT ST. LUCIE State:FL
Phone No. Zip Code: 34986 Fax: 772-492-8008
E-Mail: Phone No. 772-492-8006
Fill in fee simple Title Holder on next page( if different E-Mail: WANDA@ALLIANCEGROUPLLC.COM
from the Owner listed above) State or County License: CCC1330918
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X 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 of 0 /Lessee/Contractor as Agent for Owner Signature of C r for/license Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCRE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 28TH day of NOVEMBER 20_ by this 28TH day Of NOVEMBER 20_ by
DANIELLE BEGGS DANIELLE BEGGS
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of IderAication Type of Identification
Produce Produce
( g ature of Notary Publi -S,tr�'�fFlor �M L RYCKMAN i nature of Notary Public-State of Florida
? M MISSION#FF1455 3 �► �s
Commission No l� mmission No. '�° "`. ADJ��RYCKMAN
''.�oi� EXPIRES July 27. 201£ t �A�f MY COMMISSION#FF145513
(407)39&o153 Floridallotaryservice.com ,,?;,M1o!;.'' EXPIRES July 27, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17