HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCAMS® Permit Number:
- � Building�Permit Application FEe 13 2018
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 X
PERMIT APPLICATION FOR: Siding��� �( _
PROPOSED IMPROVEMENT LOCATION:
Address: 5407 Palm Drive
Legal "Description: Indian River Estates Unit 8 PB 1
Property Tax ID #: 3402-609-0122-000/3
Lot No. 24
Site Plan Name: Residence - David & Susan Tillman Block No. 55
Project Name: Hardie Plank Siding
25'6" 44'6" 111' 8" 12'0"
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install Dupont Tyvek membrane over existing T-111 siding, Install James Hardie Plank Siding across Side Face(s) and Top of Garage,
North Wall, East to West end, East Wall, South to North end, North Wall, East to West End. Remove and Replace existing wood trim with
James Hardie trim on corner joints of above listed walls.
CONSTRUCTION INFORMATION:
Additional work to e ertormed under this permit — checkchieck all apply:
0HVAC Gas Tank Gas Piping _ Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers ElGenerator E]Roof Roof pitch
Total Sq. Ft of Construction: 690 S . Ft. of First Floor: 2266
Cost of Construction: $ $705.00 Utilities: . Sewer P11 Septic Building Height: 15'
OWNER/LESSEE:
CONTRACTOR:
Name David & Susan Tillman
Name: Owner
Address:5407 Palm Drive
Company:
Address:
City: Ft Pierce State:FL
Zip Code: 34982 Fax:772-465-7643
City: State:
Phone No.772-465-7643
Zip Code: Fax:
E-Mail:davidtid@bellsouth.net
Phone No.
Fill in fee simple Title Holder on next page (if different
E-Mail:
from the Owner listed above)
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
°SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Name:
Address:
Address:
City: State: I
City: State:
Zip: Phone I
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _X_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone: I
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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 our Notice of Commencement.
II
Signature of Owner/ Lessee/Contractor as Agent for
wr .r
Signature of Contractor/License Holder
STATE OF FLORI
STATE OF FLORIDA
COUNTY OF
COUNTY OF
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The forgoing instrur�r nt was acknowledge efore
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The forgoing instrument was acknowledged before me
this day of 2�by
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this day of , 20_ by
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Name of person making statement
�* �o;.
;a�?•"i '••�s_
Name of person making statement
Personally wn OR Produced Identificati r3i
Personally Known OR Produced Identification
Type of Id ntifi ion
17
Type of Identification
Produced
i
I
I
Produced
(Signature of'Nota ublic- State of Florida
V1
(Signature of Notary Public --State of Florida )
Commission No. (Seal)
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i
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEWI
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17