HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEY
Date: Permit Number:
Building Permit Application SCANNED
Planning and Development Services BY
Building and Cade Regulation Division St Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof III
Address: 6805 Bayard Rd
Legal Description: LAKEWOOD PARK -UNIT 10- BLK 133 LOT 30 (MAP 13/01S) (OR 359-871)
Property Tax ID #: 1301-612-0372-000-4 Lot No.30
Site Plan Name: Re -Roof Block No. 133
Project Name:
Setbacks Front Back: Right Side:
LeftSide:
DETAILED DESCRIPTION OF WORK: III
New 5V 26 GA roof installation e4u CW �Z)N, \ b,
.�� S� C) Lsa.
CONSTRUCTION INFORMATION: III
DHVAC UGas Tank
0 Electric 0 Plumbing
Tota6Sq. Ft of Construction: 1,688
Cost of Construction: $ 29,673.00
Jcu ma—U1CLKdU apply.
Sas Piping _Shutters ❑ Windows/Doors
Sprinklers Generator R] Roof F6'.-12-1 Roof pitch
S Ft. of First Floor: 1,688
Utilities:Sewer 0Septic Building Height: _
OWNER/LESSEE:
CONTRACTOR:
Name Reece Parrish
Name: Doug Leman
Address:6805 Bayard RD
Company: Orchid Island Roofing
City: Fort Pierce State:FL
Zip Code: 34951 Fax:
Phone No.772-519-2680
Address: 856 Us 1
City: Vero Beach State: FL
Zip Code: 32960 Fax: 772-999-2101
Phone No. 772-643-5950
E-Mail:reece.parrish@bellsouth.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: doug@orchidislandroofing.com
State or County License: CCC1329687
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Name:
Address:856 us 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 recordedFrd posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lende an attorney before
commencing workX recording our Notice of Commencement.
Signature o wner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLOF;lpA .
STATE OF FLOR
COUNTY OF L1 i��i 1 1 \\44—e .
COUNTY OF t
The for oing instru,"ry\gent was acknowledg before me
The fo going instru ent wa acknowledged before me
`�
this�dayof N,&JQM� 201P by
thisrdayof�) 20,Z_ by
Name of person making statement
Narhb of per on making statement
Personally Known � OR Produced Identification
Personally Known OR Produced Identification
i Type of Identification
Type of Identification
Produced
a
Produced
(Signature of Notary Public -State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. :'t"'''-. CARAL(P—Eal AIELLS
Commission N 4 (Seal)
: MY COMMISSION p GG056546
'Aq, ,,.` EXPIRES December 20. 2020
'�""•' CARALEE WELL
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REVIEWS
FRONT
SUPERVISOR
PLANS
VEGETATION
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5
2
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17