HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INF UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��r' —0r O
Date: I� Permit Number: 1 " `7
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Building Permit Application
Planning 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 xx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED..IMPROV EMENT`CQCATION"
Address: 8400 HIBISCUS RD
Legal Description: LAKEWOOD PARK-UNIT 5-BLK 53 LOT5 (MAP 13/02S)(OR 3758-2580)
Property Tax ID#: 1301-605-0297-000-2 Lot No.
Site Plan Name: Don Glancy Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
Tear off existing shingle roof. Reroof with Owens Corning shingle
FL 10674-R10
SC � Z
CONSTRUCTI N-IN.FORMATIO,N s
Additional work toe e orme under this permit–check a appy:
HVAC E]Gas Tank []Gas Piping _Shutters Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 3500 S Ft.of First Floor:
Cost of Construction:$ 10250.00 Utilities:In Sewer 0 Septic Building Height:
OWNER/LESSEE: . CONTRACTOR:
Name Don Glancy Name: Richard Newland
Address:8400 Hibiscus Company: Richie the Roofer -
City: Fort Pierce State:FL Address: 8004 Georges Rd
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-221-1956 Zip Code: 34951 Fax:
E-Mail: Phone No. 464-4329
Fill in fee simple Title Holder on next page (if different E-Mail:
from the Owner listed above) State or County License: CCC05802 ,2050(o
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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:
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 thepermit 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.
s
ignature of Owner/Lessee/Agent 5jggelure of Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF COUNTY OF S«..e
The forgoing instrun ent was acknowledged before me The forgoing instrument was acknowledged before me
this T day of 20/. by this 14 day of "°9°S" 20 by
(Name of person acknowledging) (Name of person acknowledging)
(Signatu of Notary lic-State of Florida) (Signature of Notary Pu ic- tate of Florida)
erso a y OR Produced IdentificationProduced Identification
e o ntifica on Produced Type of Identification Produced
Commission No. ,/5Pa�MISTYBOBILIN Commission No. ,/t*7&—f; �SeaIrISTYBOBILIN
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EXPIRES:MAR 13,2017 y'� EXPIRES:MAR 13,2017
, a nsura�ce eA s ___Ie Insurance
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS