HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR
Date: y• ��,' 1-0---
TO BE ACCEPTED
Permit Number: 1 �J
Lure
Building Permit Application
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 xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
`.PROPOSED IMPROVEMENT LOCATION':
Address: 8206 Lakeland BLVD, Fort Pierce, FL, 34951
Legal Description: LAKEWOOD PARK -UNIT 8- BLK 87 LOT4 AND E 20 FT OF LOT 5 (MAP 13/02N) (OR 2228-1088 ; 3822-2340)
Property Tax ID #: 1301-608-0004-000-1
Site Plan Name:
Project Name: P167,Greer
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Tear off modify bitumen flat roofing, re -nail ldeck, install self -adhered base sheet, install self -adhered
cap sheet L/
I.CONSTRUCTION INFORMATION:
Additional work to e nertormed under this perit— check all app y:
11HVAC 0 Gas Tank ❑Gast Piping _Shutters a Windows/Doors
Electric 0 Plumbing E]Splinklers Generator Roof 1�12 Roof pitch
Total Sq. Ft of Construction: 1,400'sq ft I S . Ft. of First Floor:
Cost of Construction: $ 7,965 I Utilities: L Sewer Eleptic Building Height: 1 story
I
,,OWNER/LESSEE:
CONTRACTOR:
Name Siobhan E Greer.
Name: Chris Dutruch
Address: 8206 Lakeland BLVD I
Company: My Affordable Roof (MAC MAR, LLC)
City: Fort Pierce State: FL
Address: 1585 Kennesaw Dr.
City: Clermont, FL . State: FL
Zip Code: 34951 Fax: ' I
Phone No. 772-801-1757
Zip Code: 34711 Fax: 772-905-8694
E-Mail:
Phone No. 772-206-3344
Fill in fee simple Title Holder on next page (if different
affordableroof.comm
E-Mail: wendell @ Y
from the Owner listed above) I
State or County License: CCC1331305
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
S;UPP`LEMENTAL CONSTRUCT. I
LIEN LAW.1KCIRMATION.. "
DESIGNER/ENGINEER: _ Not Ap
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable',
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby
I certify that no work or installation has commenced prior to t
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 Co(
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:
Zip:
Phone:
made to obtain a permit to do the work and installation as indicated.
e issuance of a permit.
nit will authorize the permit holder to build the subject structure
n rules, bylaws or and covenants that may restrict or prohibit such
id review your deed for any restrictions which may apply.
The following building permit applications are exempt from unde
accessory structures, swimming pools, fences, walls, signs, scree I
WARNING TO OWNER: Your failure to Record a Notice o
improvements to your property. A Notice of Comment
before the first inspection. If you intend to obtain final
commencing work or recording your Notice of Comme
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLOYrtfl�-7)
COUNTY OF `
The forgoing instru ent was cknowledged before me
this ay of i 20_12by
/ 1A III
Name of pe, o aking statement
Personally Known jN OR Produced Identification
Type of Identification
Produced
(Sign atu e o Notary Public- State of Flori
THOMI
Commission No. ` Notary Pu
• COMM
eby agree that I will, in all respects, perform the work
s and St. Lucie County Amendments.
rgoing a full concurrency review: room additions,
n rooms and accessory uses to another non-residential use
Commencement may result in your paying twice for
!ment must be recorded and posted on the jobsite
-ing, consult with lender or an, ttorney before
cement.
Signature of Contractor/License Holder
SATE OF FLORID �
)LINTY OF
le aklay
&-jAstru en as cknowledge -before me
is oft
20�by
Name of p s ma mg statement
sonally Known OR Produced Identification
e of IdentificatiohJ
tary Public- State of Florida )
BRITTAIN
n 16. 2019
Natay Assn.
(Seal)
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Rev.8/2/17