HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date: O §�S§ Permit Number: \ rG i—da S 1
' J RECEIVED JAN 05 1016
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:NRoof — hne.-�0
PROPOSED IMPROVEMENT LOCATION::
Address: 7507 San Carlos Dr. Fort Pierce
Legal Description: LAKEWOOD PARK-UNIT 1-BLK 7 LOT 26
Property Tax[D#: 1301-601-0125-000-4 Lot No.26
Site Plan Name: Block No. 7
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPTION OF WORK:,
r
CONSTRUCTION INFORMATION:
Additional work toe nertormed under tispermit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric 0 Plumbing Sprinklers li Generator Roof
Total Sq. Ft of Construction: 1013 S Ft.of First Floor: 1013
Cost of Construction:$ 4000.00 Utilities:Sewer ElSeptic Building Height:
OWNER/LESSEE: .; CONTRACTOR:
NameH&W Real Estate Group 1?j1 Name: Larry Neese
Address:10032 U.S. Hwy 1 Company: Larry Neese Roofing, LLC
City: Port St Lucie State:Fl Address: 2801 Sunrise Blvd.
Zip Code: 34952 Fax: city: Fort Pierce State: FL
Phone No.772-370-7593 Zip Code: 34982 Fax: 772-361-6581
E-Mail:cwallengreen@hotmail.com Phone No. 772-361-6580
Fill in fee simple Title Holder on next page(if different E-Mail: Iarry(a),LNroof.com
from the Owner listed above) State or County License: FL CCC1330608
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
.SU`P;PLEMENTAIL 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 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-r - ential use
WARNING TO OWNER:Your failure -cord a Notice of Commencement may result in paying twice for
improvements to your propertotice of Commencement must be recorded a posted on the jobsite
before the firs ' pection ou intend to obtain financing, consult e e r an attorney before
comm- wor or r ordin our Notice of Commencement.
s
_Sign re of Own e essee/Agent Signatur of Contra /License Holder
ST LORIDA STA FLORIDA
COUNTY OF ��1 e COUNTY OF ��'° U���
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 'r=-> day of 20 Eby this 5 day of 3G 1 20 VP by
"..
(Name of persoh acknowledging) (Name of person acknowledging)
(Signature of Notary Pu ' -State of Florida) (Signature of Notary blic-State of Florida)
,.�� Np GIVENS loclda � NENo\F\0��d;6
Personally Known ,,.,�OR Produce®�Inti �titSr� Personally Known OR Produced I im
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Type of Identificati5h ProdIY5pc� �--- pec 16. Type of Identification Producede\h\c
Comm #EE a � +p' , o\a�y FYQT�T C�9, T'Pss°
Commission No. \ Gom*e°ka(,onalNotary Assn. Commission No. L�`�'= N;( cm) a�\�0\any
u Seal . \va�,00
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Revised 07/15/2014
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DATE
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