HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
9-14-2017 Permit Number: CAW
ED
Building Permit Application
Planning and Development Services
Building and Code Regulation Division _,z,•iIfTTING
2300 Virginia Avenue, Fort Pierce FL 34982 : , :ia County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED] MPROVEMENT LOCATION:,,,
Address: 6901 BROOKLINE AVE
Legal Description. LAKEWOOD PARK -UNIT 9- BLK 106 LOT 16 (MAP 13/01 N) (OR 4022-2777)
Property Tax ID #: 1301-611-0121-010-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION>'OF. WORK:
Tear off existing shingle roof and install Metal Fl�t9'2 and Peel and stick FL16048-R3
on a 5/12 roof pitch L % %'-
G �3
CONSTRUCTION."INFORMATION
Additional work
. to be nej orme under this permit— check a apply:
0HVAC LJ Gas Tank Gas Piping _ Shutters Windows/Doors
❑a
Electric 0 Plumbing Sprinklers E Generator Roof
Total Sq. Ft of Construction: 2800 S . Ft. of First Floor:
Cost of Construction: $ 11,000 Utilities:0Sewer Septic Building Height: 15' 12
OWNER/LESSEE:,.
CONTRACTOR:` " ;°;,
Name Manuel DeBarros
Name: Richard A. Newland
Address: 6901 BROOKLINE AVE
Company: Richie the Roofer
City: Fort Pierce State: FL
Address: 905 13th st sw
Zip Code:.34951 Fax:
City: Vero Beach State: FL
Phone No.
Zip Code: 32962 Fax: 866-610-8652
E-Mail:
Phone No. 772-464-4329
Fill in fee simple Title Holder on next page (if different
E-Mail: richieroofer@yahoo.com
from the Owner listed above)
State or County License: CGC 1512738
----- -----•-.. �............,.....vv -- nw-c, 0 ncbVfnLIGL/ IMULIGC VI L.ulumencemeni Is requires.
SL)PPLENIE�iTAL GONSTRUCTIO:N LIEN,-LAW�INFORMAT ION
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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: Richard'ANewland
Name:
Address: sodismstsw
Address:
City: Vero Beach
City.
Zip: Phone:
Zip: 32962 Phone: 772-47MI97
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.
M
Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF
re of
STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of . 20 by I this day of , 20 by
(Name of person acknowledging) (Name of person acknowledging)
&&,, MZ" 1:&t4A1'4 M",
(Signature of Notary Public- State o1FFIorida) (Signature of Notary Public- State of FlorTda )
Personally Known OR Produced Identification �� Personally Known OR Produced Identification _
Type of Identification Produced TL t; IL Type of Identification Produced C ;
Commission No. Commission No.-140000 (Seal)
,,.4�pvvy CHRISTINAMARIERODRIGUE�e rzlll CHRISTINA MARIE RODRIGUES
11
Revised 07/15/2014 *• EXPIRES; October 18, 2021 :« `
;"� a: :;r p�,. EXPIRES: October 16, 2021
• �'�FOF 4��P', Bonded Thru Notary Public Underwrlter8
'••f„jci7�°9' Bonded Thru Notary Public Undervilten
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS