HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Op
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Date: 06/08/2018 Permit Number: 1, C
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Building Permit Application 4, * lob
Planning and Development Services aoco<a i
Building and Code Regulation Division 1).0it
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 7006 Belleair Avenue, Fort Pierce, FL 34951 . ,
Legal Description:
Property Tax ID#: 1301-611-0167-000-1 '. Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace shingles and underlayment on dwelling; possibly replace one sheet of plywood if necessary;
replace small area of fascia that is rotted on east side of dwelling.
CONSTRUCTION INFORMATION:
Additional work to be erformed under this permit—check all that,apply:
OH VAC .�Gas Tank Gas Piping _Shutters I l Windows/Doors
ElElectric ❑ Plumbing 0Sprinklers ❑Generator 0 Roof 6 Roof pitch
Total Sq. Ft of Construction: 2800 S . Ft.of First Floor:
Cost of Construction:$ 2203.09 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Carol Wilson Name:
Address:7006 Belleair Avenue Company:
City: Fort Pierce State: FL Address:
Zip Code: 34951 Fax: City: State: �l
772-361-3750 1
Phone No. Zip Code: Fax:
E-Mail:johnson51199@gmail.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:carol Wilson Name:
Address006 BelleairAvenue,Fort Pierce,FL 34951 Address: 7006 BelleairAvenue
City: Fort Pierce.'.' State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLETITLE 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 your Notice of Commencement.
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/ Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instru ent was acknowledged b fore me The forgoing instrument was acknowledged before me
this ( day of �V�2_� ,20(by this day of ,20 by
act \ h Vja
Name of person making statement ` � Name of person making statement
Personally Known OR Produced Identification. V Personally Known OR Produced Identification
Type of Identification Type of Identification
Pros uced b Produced
411, s
(Sign. ure of Notary Public-Stat of Florida) (Signature of Notary Public-State of Florida )
Commission No. ;i .,,. ,,,., L(Seal)INA INGRAM Commission No. (Seal)
51 otP Notary Public-State of Floriva
)13__�� My Comm.Expires Dec 20,2016
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'1F°-`° Bo ded through National Notary Assn.
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REVIEWS DINGSUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COURTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17