HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION- TO BE ACCEPTED
Date: % / (1 Permit NuMbt:1.______ED
now 13Y RECEIVSt Lude COON Building Permit Application MAY 10 2018
Planning and Development Services Permitting Department
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
777,
AV
PROPOSED fMPROVEMENT
Address: 6901 Salerno Rd, Ft Pierce
Legal Description: Lakewood Park Unit 10
Property Tax ID #: 1301-612-0180-000/1
Site Plan Name:
Project Name: Chimney Demo
Setbacks Front Back:
Right Side: Left Side:
Lot No.16
Block No. 126
Remove existing chimney from roof (chimney not in use). Fill in void, which is between existing
trusses, with 5/8" CDX plywood, nailed to code.,
C;QNSTRUCTION (NFOR11/IATIQN,
f
A_ Additional wor to be nertormed under t is permit check all apply:
�HVAC 0 Gas Tank Gas Piping In _Shutters Q Windows/Doors
Electric 0 Plumbing ❑Sprinklers Generator 0 Roof /12 Roof pitch
Total Sq. Ft of Construction: 16 S . Ft. of First Floor:
Cost of Construction: $ 300 Utilities. Septic Building Height: 12'
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Name Lekitia Shinhoster Mitchell
Name: Douglas E Roe
Company: Code Red Roofers Inc
Address:6901 Salemo Rd
City: Ft Pierce State: FL
Address: 3341 SE Slater St
Zip Code: 34951 Fax:
City: Stuart State:FL
Phone No.786-831-9970
Zip Code: 34997 Fax: 772-287-7763
E-Mail:
Phone No. 772-287-2829
Fill in fee simple Title Holder on next page ( if different
E-Mail: becky@coderedroofers.com
from the Owner listed above)
State or County License: CRC1326582
If value of construction is 52500 or more, a KLLUKULU Notice oL Ommencement is requireu.
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IN
'DESIGNER/ENGINEER:: _•Not Applicable -
—MORTGAGE'-COMPANYv. o'.."'
_ Not Applicable
Name: Lekiga Shinhoster Mitchell
N a m e: Douglas E Roe
Address: 6901 Salemo Rd
Add ress: 6901 Salerno Rd, Ft Pierce
City: Ft Pierce State:
City: Stuart
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BLINDING COMPANY:
Not Applicable
_
Name:
Name:
Add ress: 33a1 SE slater St
i
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
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
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contra /License older
STATE OF FLORIDA
STATE OF FLORI
COUNTY OF
COUNTY OF
The forgoing instrument was acknowledged before me
TH6-fo oing instrum;rlt was Acknowledged before me
this, day of- 20�by
this _ day of 20_ by
.1VLa_U
Name of person making statement
Namk of p r� son�niaking statement
Personally Known OR Produced Identification
Personally Known .t-s'` OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
e�
(Signature of Notary Public- State of Florida)
of Notary Public- State)f FI r da
(Signatu)In
Commission No. (Seal)
CommissNo.�` �9� (Seal)
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DATE
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DATE
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Rev.8/2/17 i