HomeMy WebLinkAboutBuilding Permit Application � - I
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/18/17 Permit Number:, 01A1
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Building Permit Applicatio
N 0 V 16 2017
Planning and Development Services
Building and Code Regulation Division BY^ ........................
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial I Residential X
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PERMIT APPLICATION FOR: Roof r1'Ia,l i
ED IMPROVEMENT LOCATION:
PROPOSED I
Address: 9 96 (()ox br F�
363440 GOV LOTS 1.2 AND 3-LESS THAT PART ASSESSED IN FORT PIERCE SHORES-UNITS 1.4 AND 5- SCEOLAB Ml AND N 12 OF VAC O LYGWLY OFOAK DR AND THAT PART OF LOT 4 LYG N OF R OF FT PIERCE INLET AND
Legal Description:
W OF ATLANTIC BCH BV AND LOT 6 AND13.8 AC TRACT ADJ WLY LI OF SD LOTS 3 AND 4 IN TUCKER COVE AS IN DBK 224-72(OR 217-1336)
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Property Tax ID#: 1436-220-0000-000-8 (BLDG 2 OF 10) Lot No.
Site Plan Name: Block No.
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Project Name:
Setbacks Front Back: Right Side: Left Sidle:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL A NEW METAL ROOF
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CONSTRUCTION INFORMATION:
Additional work to e e orme under this permit—check a apply,
F]HVAC Ei Gas Tank Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing ❑Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 2900 S . Ft.of First Floor: I
Cost of Construction:$ 24,500.00 UtilitiesliSewer ETSeptic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR: !
Name Tr I A4 lrnp RL.L54- Vixn d Name: S
Address: 3g00 Cam,-n.rr OCILU .i"41n 61yd Company: Pvl
City: State:cn�0.
e Address: -_'AP-ll 5' U-S 14,0�!_ /
Zip Code: 3 a 3q Fax: City: ' State:
Phone No. —l`l ` JIG- Cb�4T a Zip Code: �39198a Fax: ��a-ulotl—(e(g(�
E-Mail: Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail: +Q Q110re "i q, oom
CCC1326177 A
from he Owner listed above State or Count �icense. ,
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION 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: I 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 fori 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF STLUCIE COUNTY OF STLUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 18 day of OCTOBER 20 1-1 by this 18 day of OCTOBER ,20 )1 by
CHARLES RICHARDS CHARLES RICHARDS
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known z OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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Ignature of Notary Public-State of Florida) (Sign ure of Notary Public-State of Florida)
vu".c FAITH MASON FAITH MASON
Commission No. * MYMMARSION#GG003939 Commission No. * �'C 11 ION#G0003939
`aQ EXPIRES:June 20.2020 f `ar
vice EXPIRES:June 20,M2020
' �F F�OQ Bonded Thru Budget Notary Sers FOF Ft oQQd ThN Budget Notary Se v ces
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17
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