HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE fINFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: Permit Number:
10
Building Permit Application
Planning and lDevelopment Services
Building and Code'Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 yes
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED INLP bV'tM6T LOCATIQN z
Address: 4475 OLD DIXIE HWY
Legal Description: 173440 FR INT S SEC 4 &ER/W US1 RUN N WLY AIG SD R/W 701.9 FT THE LY 45
Property Tax ID#: 1417-441-0003-000-9 Lot No.
Site Plan Name: 4475 NOLD DIXIE HWY Block No.
Project Name: DAVID SHELL
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
TEAR OFF OLD SHINGLE ROOF AND INTALL NEW 5V-METAL a o,
CONSTRUCTION INFORMATION
Additional work to be nerformed under this permit—check all appy:
11HVAC Gas Tank as Piping _Shutters Windows/Doors
Electric F Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: P``�� S . Ft. of First Floor;
Cost of Construction: $ Utilities: Sewer IlSepti.5 Building Height: 8
O.UUNER%LESSEE CONTRACTOR
Name Name:
HWY JOHN CANNON
Address: Company:
City: FOR I f State:_ Address:
Zip Code: Fax: City: FORT PIEHUE State: FL
Phone No.468-0202 Zip_Code: 34951 Fax: -468-0=
E-Mail: Phone No.
Fill in fee simple Title Holder on next page( if different E-Mail: Jgcannonroof 9 IC oU .COm
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEUTAW INFORMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name. COOK&MENARD AFUFIT Name:
Address Address:
City: State: City: State:
Zip: 34950 Phone: 112410WIDI Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter 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.
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Si ture o Owner/Lessee/Agent ig ture of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF COUNTY OF
The f oing instrµr� nt was acknowledged b� The forgoing inst�uent was acknowledged befor
this i' day of �/T' 20 �Jl'�' "!�: this l day of %i 20 by
7 1 �(� I` 7 m I . i,
(Name of person acknowledging) (Name of person acknowledging
g) Lidin o9O u>CD �(Signature of otary Public-State of Florida) U o _ (Signature of Notary Public-Stateof F16ridaPersonally Known✓ OR Produced Identifi 1i Personally Known OR Produced Identific
Type of Identification Produced a Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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DATE
COMPLETE
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