HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
Date.. 7-20-2015 Permit Number: 1s-z 2 D's
RECEIVEI-4
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- Building Permit Application JUL 21 2015
Planrting.and Development Services
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 rn f
PROPOSED IMRROVEMENT'LOCATION
Address: 6905 Kenwood Road Fort Pierce,FL 34951
Legal Description LAKEWOOD PARK-UNIT 10-BLK 131 LOT 17(MAP 13/01S) (OR 1635-1132:1642-1786)
Property-Tax ID#: — — L1 Lot No. 17
Site Plan Name: Block No. 131
Project Name:
Setbacks Front Back: Right Side: Left Side:
F67��AjLEDDESCRIPTIOWOP WORK:
Remove existing shingle roof.Re-nail plywood to code.
Install one ply of Tri-Built self adhering underlayment.
Install O/C Oakridge shingles qi P
CONSTRUCT,ICiN INFORMATI N.
ttiona war to e e orme under this permit--check a app y:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric Plumbing ❑Sprinklers Generator o Roof
Total Sq.Ft of Construction: 2,460 s.f. SQ. Ft.of First Floor: 2,460 s.f.
Cost of Construction:$ 9150.00 Utilities:nSewer R5eptic Building Height: 15ft
,OWNE0AESSEE:" , CONTRACTOR:
Name Robin Metzger Name:
Address: 6905 Kenwood Rd Company: The Roof Authority,Inc
City., Fort Pierce State: FL Address: 6771 N.Old Dixie Highway
Zip Code: 34951 Fax: City: Fort Pierce State: FL
.Phone No. 772-460-2483 Zip Code: 34946 Fax: 772-468-2247
E-Mail: birdy561too@att.net Phone No. 772-468-7870
Fill in fee simple Title Halder on next page(if different E-Mail: tra1993@gmail.com
from the Owner listed above) State or County License: CCCO56933
If value of construction is$2500 or more,a RECORDED Notice of Commencement Is required.
SOPPLEMENTAL,CCINSTRt1C7r1ON LIEN LAW INFORMATION:
DESIGNER/ENGINEER: y 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:
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 theermit holder to build the subject structure
which is,in conflict with any applicable home Owners Association rules,bylaws or andcovenantsthat 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,
accessorystructures,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
comme c'Mg work or recording our Notice of Commencement.
s
gnat e O L see Signat re of on racto c rise Holder
STATE OF.FLOW �, t STATE OF FLOR
COUNTY OF COUNTY OF ccn �il`Z�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 'Suk.r! 201-5 by this o2p`�'day of c t( 20 IS by
� Dk�rn Mrf7c r' hri,� LoOhl er Lone
(Na a of person acknowledging (Name of person ackn wledging)
(Signature of Notary Public-State of Florida) {Signature of N tar)Public-State of Florida)
Personally Known Liu; Personally Personally Known R ra u W dam! ti ' a 'o
Type of Identific, ng. d TRACY D'AMBROSIA _ Type of Identificati n P,� ip eA - —
:° Notary Public•State of Florida :-?° ` Notary Publlo7$ta o1 FloridaCommission No. _• •=My Comm.(@�I�sJan26,2019 Commission No. - ' = y Comm.in 26,2019And rough
Commission#FF 172298 =,,� mss;= Commissio172298
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Revised 07/15/2014
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