HomeMy WebLinkAboutRaymond Blair Slc permit appAll 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 Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7502 Eden Rd
Property Tax ID #: 1301-602-0056-000-2 Lot No 12
Site Plan Name: Blair Block No. 13
Project Name:
DETAILED DESCRIPTION OF WORK: I
Remove existing shingle roof renal deck to FBC and install Peel and stick and metal roof
Peel and Stick FL 17401-R5
Integrity Snap Lock FL F --
New Electrical Meter _ Second Electrical Meter
CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit- check all that apply:
_Mechanical — Gas Tank _ Gas Piping _ Shutters Windows/Doors Pond
_ Electric _ Plumbing — Sprinklers _ Generator K Roof 4112 Pitch
Total Sq. Ft of Construction: 2800 Sq. Ft. of First Floor: _ _ Z_4c;o
Cost of Construction: $ 13860.00
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Raymond Blair
Name: k.Gf-.�`�
Address:7502 Eden Rd
City. Fort Pierce State:
Zip Code:34951 Fax:
Phone No. t'J
Company:
Address: Q j r
City: 1.c'( State:
r,
Zip Code: '?� 7r C2- Fax:
Phone No �D_2 2— ct 21 _- 6 /C/ 7 T
E-Mail
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License
IT value OT Construction is z5uu or more, a MCORDED Notice Ot Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ..I
DESIGNER/ENGINEER: Not
Name:
Address.
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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.
41-
54rf954 of owner/ Lessee/Contractor as Agent for Owner
S' ure of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORQA]
COUNTY OF� C�j �L.l, e_
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COUNTY OF F iu CC d
The f r Ding instrum nt was acknowledged before me
The fc r ping instrum t was acknowledged before me
' /day
this day of 20 u by
t of0.yi -7�t 20 t' by
L6
f erson making statement
Name of person making statement
ll - OR Produced Identification
Personally Known _ 0R Produced identification
ification
>rod
Type of Identification
d
Produced
(Signature of Notary l b .ImPbURNW5010N 0G04"07 l
(Signature of Notary Public- Sta F o i
EXP S No 03, 202I
Commission No. ' • .• +'+ [seal)
Not �y Public State of Flo
Commission No. 5 ,�f�nda P Sanderson
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Commission GG 2112`a
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Expires 04/2512022
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DATE
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COMPLETED
Rev. 8/2/17