HomeMy WebLinkAboutbuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
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
PROPOSED IMPROVEMENT LOCATION:
Address: 8408 Hibiscus
Legal Description: LAKEWOOD PARK -UNIT 5- BLK 53 LOT1 (MAP 13/02S) (OR 3281-302)
Property Tax ID #: 1301-605-0293-000-4
Site Plan Name:
Project Name:
Setbacks. Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: I
Tear off shingle roof install new shingle roof on a 5/12 pitch
Certanteed FL # 5444-R14 with peel and stick FL # 16048-R8
Lot No._
Block No.
ACluitional work to De ertormea
L1HVAC Gas Tank
unoer this permit — check all
F]Gas Piping
Name Henry S Lawler ,Jr
apply:
Shutters
Windows/Doors
11 Electric Plumbing
Sprinklers
_
Generator
Ir_f Roof
Total Sq. Ft of Construction: 2300
S
Ft. of First Floor:.
State or County License:
Cost of Construction: $ 8000.00
Utilities:
Sewer
[]Septic
Building Height:
W I t/EE SEE: -
CONTRACTOR:
Name Henry S Lawler ,Jr
Name: Richard A. New€and
Address: 1189 Moosehead Trl Dixmont, ME 04932
Company. Richie the Roofer
City: Fort Pierce State: FL
Zip Code: 34951 Fax:
Phone No 772-913-3125
address: 6704 Santa Clara Blvd
City: Fort Pierce State: FI
Zip Code: 34951 Fax:
Phone No. 772-473-6197
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: rich ieroofer@yahoo.corn
State or County License:
It value of construction is $2504 or more, a RECORDED Notice of Commencement is required.
-SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 vour Notice of Commencement.
Rev. 8/2/17
ignature of Owner/ Lessee/Contractor as Agent for Owner
ature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLO
COUNTY OF
COUNTY OF -" U'J
The fo going instrument was acknowledg d before me
The forgoing instrument was acknowledged before me
this IC,, day of; 7 cA..4 20 11 by
day of � JCcs 201a by
i
16 //,
- ) IZ
Name of person making statement
Name of person mstatement
ersona y KrrOR Produced Identification
Personally Known r� OR Produced Identification
Hca ion
Type of Identification
Produced
Produced
s �
(Signa r, arQi Ti tE 5q
(Signature of Notary Public- State of Florida }
* MY COMM}SSIOfJ # GG 152040
Commi EXPIRES: October 10, 2oJ$eaI)
Commission No eb4iC State of F4orida
Bonded rhN Notary Public Underurfters
fir+ N tan/
Amanda P Sanderson
my commil2512022 GG 11256
or r�
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17