HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL'APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ��i- idl'�,0 Permit Number: �gl O F3
Building Permit Application 00rr �?o�
Plahp�,�
ning and Development Services Sri �,- B
Buhding and Code Regulation Division 4610 FPO
2300 Virginia Avenue, Fort Pierce FL 34982°y ent
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential XXX
PERMIT APPLICATION FOR: Roof SCANNED
PROPOSEPJ PROVEMENT ,LOCATCON BY
w.,.
il
%ddrIess: 9453 S Indian River Dr., Fort Pierce, Florida UCIe uount.
Legal Description:
19/20 36 41 N 100 FT OF S 951 FTOF GOVT LOT 3 SEC 19 LYG E OF 9/20 36 41 N 100 FT OF
RR R/W AND N 100 FT OF S 951 FT OF FRACT SEC 20-LESS RD R/W (1.46 AC) (OR 3116-825
Propi rty Tax ID #: 3519-441-0003-000-8
Site Plan Name:
Project Name:
Setbacks Front Back: _
Right Side: Left Side:
Lot No.
Block No.
r
DILED DESCRIPTION 'O ETAF WORK`F
Remo�e existing shingle roof and install peel-n-stick underlayment and install 1"26 ga mill finish standing seam metal roofing system
i
CONST ko',q. -,!PN-INFQRMATION-
Add"Itional work to be Dertormed under this permit —check all app y:
EIHVAC Gas Tank ❑Gas Piping _ Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 2141 S . Ft. of First Floor: 2141
Cost'lof Construction: $ 18,720.00 Utilities: Sewer Septic Building Height: 8
-OWNER%LESSEE
;CONTRACTOR::
Name Henry Schroder
Name: Wanda Gahn
Address. S Indian River Dr
Company: WVVW Enterprises & Son, Inc.
City: Fort Pierce State:Fl
Address: 8833 Lonesome Pine Trail
Zip Code: 34982 Fax:
City: Fort Pierce State: FI
Phone No.305-608-1232
Zip Code: 34945 Fax:
E-Mail:
Phone No. 772-465-9373
Fill in fee simple Title Holder on next page j if different
E-Mail: wandagahn@aol.com
from the owner listed above)
State or County License: CCC1326015
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL;CONSTRUCTION LIEN LAW INFORMATION
}
t
6t1�'�Jn��Y F�.,I�Fi id:^{�n !•�,�k`. ��`r+f'�vFh .�. ��, iva. �^uF �P.k,a 7A,n v is .s, %' P � } ��..�
�.. � }a,ib ,x n.,.�"..�Rx t��5 '. 'Y:+.� ��1�'
ro aY, 1,"!'.,'F��..., Ra •� .e.{i�
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
Not Applicable
Name:
Name:
_
Address:
Address:
City: State:
City: Fort Pierce
State:
Zipl: Phone
i
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
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
commencing work or recording our otce of Commencement.
Signature of Owner/ Lesse /Contractor s Agent fo
yt� ,,,
ignature Contractor cense Holder
:;•...:�°
STATE OF FLORIDA
STATE OF FLORID -
a
m
COUNTY OF
COUNTY OF
�
2 m9
The;foring instru t was acknowledge"efor
g �
The for ing instru ent was acknowledged of
this day of 20 by
rn P)
this) day of 20 by
Z m
sg
d Cn Q7
•C �T i,
i
Name of perso aking statement m� =
Name of person making statement . • �N _
�
Personally Known OR Produced Identifica __ -
�N
Personally Known OR Produced Identifi tion
Type of Identification
Type of Identification
Produced
Produced
04.4 ht nJ4,4-
(Signature of N ary Public- State of Florida
(Signature of No ry Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
i
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
d
tev. 8/2/17