HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: NOV,15/19 Permit Number:
NOV 2 1 nig
Building Permit Applic fan
Planning and Development Services ST, Lucie County, Permitting
Building and Code Regulation Division
2300 Wrginia Avenue,fort Pierce FL 34982
Phone: (772)-462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT TYPE: REROOF
WRAP
Address: 5495 MCDONNELL DR_ FORT PIERCE,FL.34951
Property Tax ID#: 1301-614-0181-000-4 Lot No. 9
Site Plann,Name: KELLIE BLOCK Block No 164
Project Name: KELLIE BLOCK
REAIR OFF OLD ROOF IN BACK INSTALL TORCH DOWN AND MAIN HOUSE 5V-METAL
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Windows/ ors
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_Electric _Plumbing _Sprinklers _Generator Roof 12,- Pitch
Total Sq. Ft of Construction: 2000 Sq. Ft.of First Floor: 2000
Cost of Construction:$ 9000.00 Utilities: _Sewer _Septic Building Height:
Name KELLIE BLOCK Name: JOHN G CANNON
Address: 502 N LITTLE VICTORIA RD. Company: John Cannon
City: WOODSOCK,OA State:_ Address: 7901 CITRUS PARK BLVD
Zip,code: 30189 Fax: City: FORT PIERCE Sate: F
Phone No. 404-369-2589 Zip Code: 34951 Fax: 772-468-0272
E-Mail: Phone No 772-468-0202
Fill in fee simple Title Holder on next page(if different E-Mail JGCANNONROOFt&ICLOUD-COM
from the Owner listed above) State or County License CCC1330664
N value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicablefi
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 irrconflict withany applicabtekiome Owners Assoctatiorr rales,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 iIN YOUR PAYiING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOT110E OF COMMENCEMENT'MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WrEH YOUR.LENDER OR AN ATTORNEY BEFORE RECORDING YOUR.NOTICE OF COMMENCEMENT."
ignatu of Owner/Lessee/Contractor as Agent for Owner Signa re of Contractor/License Holder
STATE OF FL"DA STATE OF FLORIDA
COUNTY OF • COUNTY OF -S V. X-.uc'%R
The forgoing instru ent was acknowledged before me The forgoing instrum ent was acknowledged before me
this 8.\ day of Q a� .20 by this`d.\ day of N6 .20 4 by
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Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type.of IdentificationType of Identific tion
Produced ProducedFeel
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(Signature of Notary blic-State of Florid` s (Signature of N Vie-StatewIli ffl
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REVIEWS F '"' OEOMNG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
co R REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19