HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED U
Date - � O ` (. SCANN Permit Number:
RECEIVED
Building Permit Application APR 10 2018
Planning and Development Services I
Building and Code Regulation Division II ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof l PROPOSED. IMPROVEMENT LOCATION:
Address: 7503 Palomar Street
Legal Description: Lakewood Park- Unit 1- BLK 9 Lot 24 (Map 13/14N) (OR 2148-1538)
Property Tax ID #: 1301-601-0182-000-1
Site Plan Name: Povlitz
Project Name: William Povlitz
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: !,
Repair 7 SQ shingle roof & Remove and Replace 4 SQ'of Modified Bitumen flat roof
Lot No.24
Block No. 9
CONSTRUCTION INFORMATION:
Add ltiona I work to be performed under this permit —check
�HVAC Gas Tank ❑Gas Piping
all apply:
In Shutters
Q Windows/Doors
Electric Plumbing
Sprinklers
',Generator
Roof nz&sn2 Roof pitch
Total Sq. Ft of Construction:
S . Ft. of First Floor:
Cost of Construction: $ 2500.00
Utilities:
Llsewer
1
0
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR_:'
Name William & Julianne Povlitz
Name: Danielle Beggs
Address:7503 Palomar Street
City: Fort Pierce State: _
Zip Code: 34951 Fax:.
Phone No.
Company: Alliance Group
Address: 532 NW Mercantile PL #113
City: Port St. Lucie State: FL
Zip Code: 34986 Fax: 772-492-8008
Phone No. 772-492-8008.
E-Mail: wanda@alliancegroupllc.com
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CCC1330918
It value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCT)ON LIEN 'LAW)NFORMATION:
DESIGNER/ENGINEER: v Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: v Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: V Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Applicable
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 per
which is in conflict with any applicable Home Owners Associatic
structure. Please consult with your Home Owners Association a
In consideration of the granting of this requested permit, I do h
in accordance with the approved plans, the Florida Building Coc
II authorize the permit holder to build the subject structure
!s, bylaws or and covenants that may restrict or prohibit such
Fiew your deed for any restrictions which may apply.
by agree that I will, in all respects, perform the work
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 vour Notice of Commencement.
Signature of
ctor as Agent for Owner 11 Si ature of Cdglractor/License Holder
STATE OF FLORIDA / ` I STATE OF FLORIDA
COUNTY OF Tl��f COUNTY OFF (JC/ &
The forgoing instrument was acknowledged efore me
this day of ;^ 20by
Name of persomAiKg statement
Personally Known OR Produced Identification
Type of Identification
Produced
The forgoing instrum nt was cknowledged before me
this day of &4r 20U by
y1ne l°l _ aS
Name of perso ma statement
i Personally Known OR Produced Identification
jType of Identification
Produced
(Signature of Notary Pu lic- State
of Notary P ic- t
,
AVID ALAN JOH
Commission No.
� ar r .
� tiP Gg i
,,, DAVID ALAN J
,_ aJ�tate of Florida -No
_ Commission # G
FiNSON
apbi,l'
172248
n No. 7
"Y° ��, State of Florida-Notar
J W, V,,
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=�, My commission E)
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My Commission
Expires
•a:
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03, 201
January 03,
022
0;;,`,°`'
January
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17