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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �d� • �J �. Permit Number: 17 a ` ¢�
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Building Permit Application DEC 15 2017
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 ;v .
PROPOSED, IM,PROVEMENl"�LOCATION;;, - _ ._ -
Address: 7606 Bayard Road, Fort Pierce, FL
Legal Description:
LAKEWOOD PARK ADDITION NO 1-BILK A LOT 26(OR 1756-2977)
Property Tax ID#: Parcel ID: 1302-810-0026-000-5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF.WORK. _
Remove existing shingle roof system, renail plywood to building code, dry roof in with self-adhered underlayment,
install Owens Corning Duration shingles and accessories.
CONSTRIJ.CTION',INFO.kMATION
i lona work oe. a orme under is perms —check a appy:
HVAC 11 Gas Tank ❑Gas Piping OGenerator
Shutters Windows/Doors11 Electric 0 Plumbing [:]SprinklersSprinklers Roof 1 f a
Total Sq. Ft of Construction:- 2,489 S Ft.of First Floor:
Cost of Construction:$ 12,100.00 Utilities:
Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTO,Rs
Name Michael A. Hefley Name: Christopher A.Long
Address: 7606 Bayard Road Company: The Roof Authority,Inc.
City: Fort Pierce State: FL Address: 6771 North Old Dixie Highway
Zip Code: 34951 Fax: City: Fort Pierce State: FL
Phone No. 772-979-0457 Zip Code: 34946 Fax: (772)468-2247
E-Mail: no email address Phone No. (772)468-7870
Fill in fee simple Title Holder on next page(if different E-Mail: tral993@gmail.com
from the Owner listed above) State or County License: CC C056933
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEM€NTALCONSTRU.CTION 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:
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.
s
_Signature of Owner/Lessee/Age Signature of Con �rILUnse Holder
STATE OF FLORIDA STATE OF FLORI
COUNTY OF St. Lucie COUNTY OF St. Lucie
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 14y of November 20 —by this 21 rAay of November 20 17 by
Michael-4A. Hefley Christopher A. Long
(Name of person acknowledging)Owner/Lessee/Agent Printed Name (Name of person acknowledging)Contractors Name
T'rn,C F—L)'soA— IVfnrr7h4A IA)Sw IaY—
(Signature o Notary Public-State of Florida) (Signature of)Notary Public-State of Florida)
Personally Known uWWWiYYcAbTTi O►'D( Personally Known X TIMOTHY'Al.SUTTON
Type of IdentificatnFF
iV� `�Pt) Type of Identification Prod eek_
a STAT OF FLORIDA r:i
Commission No. Corri(gIk 104511 Commission No. FF 1045'tF �q � a�104511
El Expires 3/20/2018 xp es 3'/20/2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS