HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
te: 08/08/18 SCANNED Permit Number: - 011D
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II . Building Permit Application 43AI3�3a
r�!�nmg and Development Services
)ding and Code Regulation Division
)0 Virginia Avenue, Fort Pierce FL 34982
D,pe: (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 IMPROVEMENT LOCATION:
AddreL, 7603 Winter Garden Pky, Fort Pierce FI 34951
Legal Description: LAKEWOOD PARK -UNIT 5- BLK 42 LOT27 (MAP 13/11 N) (OR 3513-496)
Property Tax ID #: 1301-605-0069-000-5
Site Pla Name:
Project-�III ame:
Setbaclts Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
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5 ll� r0 __'Pl4ck 0400 9!19 mil- 1Ceb149-RU
CONSTRUCTION INFORMATION:
Addition4lwor to a ne orme under this permit— check a apply:
_ HV C _ Gas Tank ❑Gas Piping _ Shutters Windows/Doors
Ele Iris 0 Plumbing OSprinklers Generator Roof
Total Sq. Fof Construction: S . Ft. of First Floor:
Cost of Co Istruction: $ 11� _56b Utilities Sewer ElSeptic Building Height:
'OWNER/LESSEE: -
CONTRACTOR: "
'
Name Keithlaig
Name: Richard A. Newland
Address: 6806 61st St
Company: Richie the Roofer
City: Vero Bach State: FL
Address: 905 13th st sw
Zip Code: 32967 Fax:
City: Vero Beach State: FL
'Phone No.
Zip Code: 32962 Fax: 866-610-8652
E-Mail:
Fill in fee simliple Title Holder on next page (if different
Phone No. 772-464-4329
E-Mail: dchieroofer@yahoo.com
from the Ow i er listed above)
State or County License: CGC 1512738
it value of construction is SZ50o or more, a RECORDED Notice of Commencement is required.
auwK7JVCK/CIVGIIiIEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State•
Zip: __Phone•
FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY:
Name: Not Applicable
Address: Name:
Address:
City: City.
Zlp: Phone:
I Zip: Phone:
,iWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I ertify 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
whtich is in conflict with any applicable Home Owners Assocition rules,bylaws orand permitants that build
prohibit such
st iucture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In �ponsideration 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.
Thee following building permit applications are exempt from undergoing a full concurrency review: room additions,
3c�essory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
twice for
*rovements;
RNING TO OWNER: Your failure to Record a Notice of Commencement may result in ourpaying
to your property. A Notice of Commencement must be recorded and your
na jobsite
)efore the first inspection. If you intend to obtain financing, consult with lender or an attorney before
:othmencing work or recording your Notice of CnmmPnram-n+
1
3ture of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
TE OF FLO STATE OF FLO
)NTY OF _ 1 ["1 COUNTY OF -
ing instr ent was a 'knowledged before me
day of •�- 261—A by
Name of person making statement
finally Known t OR Produced Identification
of Ide�Cii if;rattr,., %r rr\
of Notary
Com
Nort��yy__--P}}��blic State of Florida
Ani�11P Sanderson
My Commission GG 211256
'-Expires 04/2512022
FRONT I ZONING SUPERVISOR
COUNTER REVIEW REVIEW
Rev.
The f rgoing instr ent was cknowledged' before me
t day of 26X by
Name of person maw statement
Personally Known OR Produced Identification
Type of Identification
Produced
(Signature of Not Public- State of Florida)
ommission No. IIV tery Public State of
aP(manda P Senders
My commission GG 2
rp
Expires 0412512022
PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW