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HomeMy WebLinkAboutBuilding Permit Application 8475803 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5 Permit Number: scl -09 a,4 © e RECEIVED AUG 2 7 2015 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 X PERMIT APPLICATION FOR: Roof - PROPOSED IMPROVEMENT LOCATION Address: 8104 Lakeland Blvd. Fort Pierce, FL 34951 Legal Description: LAKEWOOD PARK-UNIT 8- BLK 87 LOT1 (MAP 13/02N)(OR 714-1245) Property Tax ID#: 1301-608-0001-000-0 Lot No.1 Site Plan Name: Block No. 87 Project Name: Bywaletz,#8475803 Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK. Re-roof 35 squares of asphalt shingles and 6 squares of flat roof CONSTRUCTION INFORMATION Additional work to be performed under this permit–c ec a at appy: ❑ HVAC Gas Tank Gas Piping Shutters— ❑ p g ❑Windows Doors Electric ❑ Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$" 18,000.00 Utilities:In Sewer[]Septic Building Height: OWNER/LESSEE " :CONTRACTOR Name Klaus Bywaletz Name: Quinn Roberts Address:8104 Lakeland Blvd. Company: The Home Depot At Home Services City: Fort Pierce State:FL Address: 674 S Military Trail Zip Code: 34951 Fax: City: Deerfield Beach State:FL Phone No.(772)646-1936 Zip Code: 33442 Fax: E-Mail: Phone No. (954)379- 1500 Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: CCC058327 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. CTION LIEN LAW INFORMATION SUPPLEMENTA[ CONSTRU �. , a . .A .. .. 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 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 fir ' pection. If you intend to obtain financing, co �*t hlender or an atto y before comm n work)pr recordingour a ommenc ent. Signature of Owner gent/ essee Signature of Ctractor/License Holder STATE OF FLO STATE OFF GRID COUNTY OF COUNTY OF L The forgoing instru nt was knowledged before me The forgoing instrugient was acknowledged before me this day of 20 15 by this�s day of 20 15 by Quinn Roberts Quinn Roberts (Name of person acknow dging) (Name of person ackno ledging) &'6 101,11 (Signature of otary ub ic-State of Flori a) (Signa ur6/16M6 ry Public-State of Florida) Personally Known X OR Produced Identification Personally Known X OR Produced Identification Type of IdentificationProducedType of Identification Produced Commission No. LG a I5'6Ta (Seal) Commission No. (Seal) AMBER FLENK R AMBER FLENKE NOTARY PUBLI '40%NOTARY PUBLIC STATE OF FLORIDA Revised 07/15/2014 Comm#EE215692 `Comm#EE21569 'r�cFtExpires 7/11/2011; REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE CO MP LETE INITIALS