HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
Date: j /� Permit Number:
Building Permit Application DEC 2 6 2017
Planning and Development Services PSR'J7iT-Ti:�G
Building and Code Regulation Division St. Lucie Cot3nty, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential yes
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: `
Address: 16 I(r,V �5� �E L Ut.�A
Legal Description: SEC 01[TOWN 34S/RANGE39E
Property Tax ID#: 1301-111-0001-000-5 Lot No.
Site Plan Name: WILLIAMS,RACHAEL Block No.
Project Name: WILLIAMS,RACHAEL
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: �c't le, ow
TEAR OFF OLD SHINGLE ROOF AND INTALL NEW 3 TAB SHINGLES
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that appy: ✓
HVAC _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _ Plumbing _Sprinklers _Generator Roof
Total Sq. Ft of Construction: 2800 Sq. Ft. of First Floor: 1000
Cost of Construction: $ 6000.00 Utilities: —Sewer Septic Building Height: 8
OWNERAESSEE: CONTRACTOR:
Name VVILLIAMS,HAUHEALName: JOHNUANNUN
JOHN UANNUN
Address: IS �` Company:
City: FORT PIEHUE State:IFE_ Address: 7901 UITRUS PARK BLVD.
Zip Code: 34951 Fax: City: FOR State: FU
Phone No.468-0202 Zip Code: 34951 Fax: -468-0=
772-4680202
E-Mail: Phone No.
Fill in fee simple Title Holder on next page ( if different E-Mail: jgcannonroo IC oU .Com
from the Owner listed above) State or County License: yZ 9
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
t32,33Ll
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: COOK&MENARD AFLCRT Name:
Address ; Address:
City: State: City: State:
Zip: 34950 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
_Signa re of Owner/Lessee/Agent Signat e ciContractor License Holder
TE OF FLORIDA II STATE OF FLORIDA
COUNTY OF _ . L1� COUNTY OF '4, L�Icir
The for oing instr ment was acknowledged�t efore me The forgoing instr ment was acknowledged before me
this Zday of � 20 rel by this�(�day of 20 by
Nl�kl CA4%1nW - �\() �KI
(Namebf person acknowledging) (Name of person acknowledgingAAA )
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Personally Known I/ OR Produced Identification Personally Known ✓/ OR Produced Identification
Type of Identification Type of Identification Produce
,•;.�
KAREN. S. NIELSEN .��;a+r KAREN S. NIELSEN
Comm' # FF 115637 Commission No. , ' ( nission# FF 11563
Commission No. -`� •_ (sl�
a. My Commi sion Expires My Commission Expires
June 12, 2018 '+;� ;,,r� June 12, 2018
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS