HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/1/2017 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 XX
PERMIT APPLICATION FOR: Roof -
PROPOSED'IMPRO.VEMENT LO:CATIQN
,
Address: 16101 Carlton Adams Rd., Fort Pierce, Florida 34945
Legal Description: LUKE'S LOTS(PB 41-4)LOT 10(7.554 AC)(OR 3599-254
Property Tax ID'#: 2236-700-0010-000-3- Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK ,
*.... «r. h - t
REMOVE EXISTING ROOF, REPLACE ANY DRY-ROT, RENAIL TO CODE, DRY-IN WITH
PEEL-N-STICK, INSTALL 5-V crimp 26 ga metal.roofing system
F ,
CASNR_ N IN
' ' CTIOFORMATION ry
Additional work to be nertormed under this .
permit—check all =ers
HVAC Gas Tank ❑Gas Piping E]Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 890 S . Ft.of First Floor: 1080
Cost of Construction:$ 19200 utilitiesl]Sewer Septic Building Height: 9
011UNER/LESSEE CONTRACT
OR:
_ j
Named Name: Wanda Gahn
Address: Company: WWW Enterprises&Son, Inc.
City: Fort Pierce State:Fl Address: 8833 Lonesome Pine Trail
Zip Code.�y,�_ Fax: City: Fort Pierce State:FI
Phone No. .: '7 Zip Code: 34945 Fax:
E-Mail: Phone No..772-465-9373
Fill in fee simple Title Holder on next page(if different E-Mail:.wwwent@netzero.com
from the Owner listed above)' State or County License: CCC1326015
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTR;UGTI:ON 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/Agentignatur ontracta `ice se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �' `.o COUNTY OF JA, .Q _
The fo going instrq ment was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 Jaby this 4—day o`F—Dnoank 20 LJ by
3 ()J0uJA .
(Name of person acknowledging) (Name of person acknowledging)
(Si ure of Notary Public-State ofSlorida) (Signature of Notary Public- to of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced _ r Type of Identification Produced
LASH�a INGRAM ``osPaY��eLA HAHJ,A INGRAM
Commission No. ,�`�aY�Aue'�% Commission No. II
otary p,(g5e,ai)State of Florida Not, F I N �State of Florida
My "Omm.Expires Dec 20,2018 _'. My Comm.Expires Dec 20,2018
• F 177249
iE OF F��``�
'rFOF ; Bonded through National Notary Assn_I� „,,,,.. Bonded thr,uoh Nativat Notary Assn.
Revised 07/15/2014". .i- .,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS