HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� uI Q
Date: January 7, 2019 SCANNED Permit Number: L -1 D1.O I � V
BY
St. Lucie County
• RECEIVED
Building Permit Application JpN 3 2019
Planning and Development Services
Building and Code Regulation Division ST, Lucle ceunt9, WmNtln
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
PROPOSED IMPROVEMENT
LOCATION:
__ _
Address: 5105 Turnpike Feeder Road
Legal Description: Lakewood Park - Unit 12-A-BLK 168 Lot 3 (Map 13/13N) (Or 3783-85)
PropertyTax ID #: 1301-615-0021-000-8 Lot No.3
Site Plan Name: Boyle A/C Block No. 168
Project Name: Boyle A/C
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Re -Roof of the front portion.(axom a) s 1� ,-'07—
CONSTRUCTION INFORMATION: _
itiona wor to e e orme unciert ispermit—check a apply:
0HVAC GasTank []Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: 3 squares S . Ft. of First Floor:
Cost of Construction: $ 4,895.00 Utilities: 0Sewer Septic Building Height: Mansard
OWNER/LESSEE: _
CONTRACTOR! _
Name Michael Boyle
Name: Michael R Black
Address:7503 Pacific Ave
Company: MB Enterprises Roofing & Sheet Metal,
city: Ft. Pierce state: FIL
Address: 540 2nd Street SW
City: Vero Beach State: FL
Zip Code: 34951 Fax:
Phone No.
Zip Code: 32962 Fax: (772) 569-4781
E-Mail:
Phone No. (772) 562-7549
Fill in fee simple Title Holder on next page (if different
E-Mail: mberoofing@gmail.com
State or County License: CCC032498
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:540 2nd Street SW
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 Notice of Commencement.
Signature f Owner/ LesseePnfr5ctW5sAgent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA ;5 I ,,;�
STATE OF FLORIDA
COUNTY OF Ltnl t
COUNTY OF / n.i.t, . eyti '
The forgoing instrument was acknowledged before me
The f�r oing instrurpwt was acknowledged before me
this]�iti da.(yo�f, ^ 20 tom' by
this T d``ay of ..lan. �n{.�� . 20 (� by
IV6I`UIY.IiJil,�y�e/
Name of person�naking tatement
Name of person making statement
Personally Known ✓ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
JAI
(Sign rp•,gP;tary PuKM Stl )
fE
(Signature
o t 'c- t e
CHRISTINE J. CONWELL
pp- MY COMMISSIO
�' January 30, 2027
Commissi
rg c • State &Whda
Comm' EXPIRES: u6e )
• Commission 0 GG 017839
My Comm. Expires Aug 21. 2020
REVIE S
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
R NT
ZONING
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17