HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMF iD FOR APPLICATION TO BE ACCEPTED
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
SCANNED Permit Number: qb -
BY
St. Lucie County
Building Permit Application per ga9����2Fo
Commercial Residential x t'e,
PERMITTYPE: ROOF
PROPOSED IIVIPROUENIENT LOCATION:
7501 MIRAMAR AVE.. FORT PIERCE FL. 34951
Property Tax ID #: 1301-601-0069-000-3
Site Plan Name: LAKEWOOD PARK UNIT 1 BLK 5 LOT23
Project Name: ROMAN KLINEC
REPLACE FLAT ROOF ON BACK OF HOUSE AND FRONT IN 5
"xl�r7--161Q; - m g�v
Additional work to be performed under this permit —check all that apply:
Lot No. 23
Block No. 5
_Mechanical
_Gas Tank
_Gas Piping
_Shutters
Windows/Doors
Electric
_ Plumbing
_ Sprinklers
_ Generator
Roof Pitch
Total Sq. Ft of Construction: 33 66 Cost of Construction: $ I in
_0�
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
(3WNER/LESSEE: __
CONTRACTOR:
Name ROMAN KLINCE
Name: JOHN G CANNON
Address: 7501 MIRAMAR AVE
Company: JOHN G CANNON
City: FORT PIERCE State:_
Zip Code: 34951 Fax:
Phone No. 468-0202
Address: 7901 CITRUS PARK BLVD
City: FORT PIERCE State:_
Zip Code: 34951 Fax: 7724680272
Phone No 7724680202
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail JGCAN NON ROOF@ ICLOUD.COM
State or County License <2rCre ' O
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
LIPPLEMENTAL;CONSTft .
..-
.LIEN LAW IRI.FQRMATIQIV:
- a. _ 4° ,
DESIGNER/ENGINEER: _
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City:' State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Name:
Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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 JOB SITE BEFORE THE FIRST INSPECTION_ IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING -YOUR NOTICE OF COMMENCEMENT."
o Ow essee/Contractor as Agent for Owner
7ATE
ign/at Contractor/License Holder
OF FLORID��---�
ATE OF FLORIDA�
COUNTY OF i r `o� _
COUNTY OF LY L.r f �1�
The forgoing instrument was acknowledged before me
this day of 20j� by
The forgoing instrument was acknowledged before me
thisLd'ay of 20 by
Name of person making statement.
Name of person making statement.
Personally Knot�n OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Produced Fc pL
vv�
Type of Identification
Produced
(Signature of No
GHN`
(Signature of ® ��-S t�
Commission No.
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Sew State of Florida Notary Public
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2///ly