HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONC.
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7
Date: January 19, 2017 Permit Number: ' ((o i - 0 537
-- 6L;HNNED
Building Permit Application BY
Planning and Development Services f 1101P Counivv
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X _ Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
Address: 4645 North US 1. Fort Pierce FL
Legal Description:
Property Tax ID #: 141660100590003
Site Plan Name:
Project Name: Sunny Island RV
Setbacks Front Back: Right Side: Left Side:
('DETAILED DESCRIPTION OF WORK:
Remove existing shingle roof. Install a self adhered underlayment and new Owens
Lifetime Dimensional Oakridge Shingles.
Lot No. 5
Block No. 17
.CONSTRUCTION INFORMATION:
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Aclaitional work to be ertormed un
Gas Tank
er t is permit— c ec
❑Gas Piping
a app y:
❑
nn❑HVAC
0
_ Shutters
Windows/Doors
Lei Electric Plumbing
Sprinklers
Generator
Roof
Total Sq. Ft of Construction: 1,129
Sq. Ft. of First Floor:
Cost of Construction: $ 5,230.00
Utilities: 0Sewer 0 Septic
Building Height: 9'
Address: 1569 Barclay Boulevard
City: Grove State: IL
Zip Code: 60069 Fax:
Phone No.815-501-1701-
E-Mail: Service@sunnyislandrv.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: —Christopher Long
Company: The Roof Authority, Inc
Address: 6771 N. Old Dixie Hwy
City: Ft. Pierce State: FL
Zip Code: 34946 Fax: 772-468-2247
Phone No. 772.468-7870
E-Mail: tim@theroofauthorityg&Eafl.com
State or County License: CCC56933
of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
MORTGAGE COMPANY: — Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip: Phone: I Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
_Not Applicable
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 ana 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
/� your Notice of Commencement.
s
_ Signature o wner/ Lessee &' en Signa ur f cc itrac Lice se Holder
STATE OF FLORIDA St. Lucie STATE OF FLORID
COUNTY OF COUNTY OF St. Lucie
The for oing instrument was acknowledge efore me I The for oing instrument was acknowledged �efore me
this 1 �tl'Ilay of January 20 0 this �t�ay of January z0 _by
Victoria Diane McKuhen Victoria Diane McKuhen
(Name of person acknowledging) I (Name of person acknowledging )
r/a/t)rti"t' k1/nnno Afl- Xpr) rJ-rlial A`Il,nna —NClic A
(Signature of Notary Public- State of Florida ) (Signature of Notary Public- State of Florida )
Personally Known OR Produced Identificati n X Personally Known X OR Produced Identification
Type of Identification Produce 6 Type of Identification Produced
V TTO_I IA DIANNE McKUHEN
Commission NO. 8 S ssIoNaFF99a79s Commission No. f=F99e795
e:wiaFs:rwysi,zozo 6 VICTORIA DIANNE McKUI
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Revised 07/15/2014
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