HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�v
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
12/05/2017 2,; )
Date: Permit Number:
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Building Permit Application ;
Planning and Development Services 1
DEC e��
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 PERMITTING i
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential. Xucie County,1=L
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 7001 Paso Robles Blvd
Legal Description: LAKEWOOD PARK -UNIT 9- BLK 105 LOT 26 (MAP 13/01 N) (OR 933-1912) %
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Property Tax ID #: 1301-611-0104-000-2 Lot No.26
Site Plan Name: Block No. 105
Project Name:
Setbacks Front Back: Right Side: , Left Side:
DETAILED DESCRIPTION OF. WORK: ,'V
remove roll composition roofing, replace rotten plywood replace roof with metal roofing.
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CONSTRUCTION INFORMATION:
itiona wor to e e orme under this permit —check a apply: /
OHVAC ❑Gas)Piping 'QWindows/Doors
Gas Tank Shutters
pEl I Z Roof / 2 Roof pitch
Electric 0 PlumbingS/ rinklers Generator
Total Sq. Ft of Construction: 1500 / 885 %
S Ft. of First Floor:
Cost of Construction: $ 2200 -
Utilities: Sewer �Septic� Building Height: feet
_
/LESSEE: CONTRACTORf,
�� '
d L Nester Jr
Name:
08 Kin 9s Highway 1Com
r
anceFLp yState:'34951 Address
Fax:
Phone No. 772-464-1553
E-Mail: rsmith379529@yahoo.com
Fill in fee simple Title Holder on
from the Owner listed above)
If value of construction i $$2500 or
d
page (if different
ter.
Zip Code:
i Fax:
Phone No.
E-Mail:
State or County License
a RECORDED Notice of Commencement is
State:
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: Not Applicable
N a m e: Harold L Nester Jr
_
Name:
Ad d ress: 7001 Paso Robles Blvd
Address: 6508 Kings Highway
City: Ft Pierce 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
is in Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
which conflict with any applicable
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 job site
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our No iceuof Commencement.
ig ature of Owner a e/ for as A nt for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF ` 1,1 �1 E
COUNTY OF,
The forgoing insti ent was acknowledg d before me
The forgoing Instrument was acknowledged before me
this day of 20_" by
this day of 20_ by
�YA_ kum ��6LK r
Name of person making statement
Name of person making statement
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identif' aon
Type of Identification
Produced-- — �—
Produced
44 c9----
(Signature ofNotary RE ,,, KAS. NIELSEN
(Signature of Notary Public- State of Florida)
gar ruB�4�.
a n N F F 1 1 5637
Commission No. ;r ,_ Com_(Sb
My Commission Expires
Commission No. (Seal)
dam:
'• for r�°� June 12, 2018
O,ryu,p�p•
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SUPERVISOR
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REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17