HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ c�
Date: 4-17-15 Permit Number: f�A_1�1 r
RECEIVED
Building Permit Application Yep/
Planning and Development Services MAY ' ' 2015
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROV EM ENT;LOCATION • . .' `!
1
Address: 36 Impanema Way
Legal Description:
Property Tax ID#: I S V 1 X00 09 -72 ® 30 Lot No.
Site Plan Name: Robert Moore Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF VI/ORK
_.
Install metal roof FI 11651.12 R1 Tear off existing shingle roof.
170 SqL, reP�I-ck
CONSTRUCTION INFORMATION
:. ..,, .
Additional work toe e orme under this permit—check a appy:
HVAC Ei Gas Tank E]Gas Piping _Shutters 0 Windows/Doors
11 Electric E]PlumbingO Sprinklers I Generator 7 Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ 2490.00 Utilities:cn Sewer Septic Building Height:
D,W" "' CONTRACTOR
�.. . _
Name Robert Moore Name: Chat) A)w IG
Address:36 Impanema Company: Richie the Roofer
City: Ft. Pierce State:Fl Address: 8004 Georges Rd
Zip Code: 34951 Fax: City: Ft. Pierce State:FL
Phone No.410-259-1929 Zip Code: Fax:
E-Mail: Phone No. 772-473-6197
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 20506
If value of construction is$2500 or more,a RECORDED Notice of commencement is required.
SkJP� LEMENTAI.CQNSTRUCTION LIEN LAW IN rORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 Notice of Commencement.
ignature of Owner/Lessee/Agent cgli ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF _�. Lu( 1r- COUNTY OF �% L 1 -6 (�C
The forgoing instrument was a knowledged before me The for oing instrument was acknowledged efore me
this._U day of 20/,5 by this day of (na Y 20 15 by
(Name of person acknowledging) ;' (Name of person acknowledging)
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(Signature f Notary Public-St a of FI r da) 2 (Signature of tary Public-State of Florida) a
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Personally Known OR Produced IdentificatiPersonally Known OR Produced Iden fid
Type of Identification T`� Type of Identification 7.T
Produced -2oA s Producedp
Commission No. (Seal) Commission No. (SE 111.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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