HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED — 001
Date:
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Date: Permit Number: 1�Qr �'�l I 1
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Building Permit Application FEB 2 x'2016
Planning and Development Services
Building and Code Regulation Division PEPrOITTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential >O
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P.ROPOS_ED IIVIPROUENI�ENT LOCATfbh
Address: 2220 JERNIGAN RD
Legal Description. FONT PIERCEGMUENS OF 21�39 BLKF FROMNWCORLOT I RUN ELY 30FT.TH SLY30FT TOPOB.TH CONT SLY I8WFT.TH ELY 291A5FT TO PT 10 FT WOF E LI LOT I.TH NLYLTOSDE LI IS4M FT.TH MY ONL130 FT S OF,
Property Tax ID#: 2321-501-0001-000-7 Lot No.
Site Plan Name: Cooley Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DE SCRIPTION OF WORK13
Tear off existing Shingle roof install a peel and stick underlayment and metal roof. �I�.� P i'+r-
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CONSTRUCTION IN R'MATION
Additional workto e e forme under tis permit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
1-1 Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction:. 3600 5 . Ft.of First Floor:
Cost of Construction:$ 17400.00 Utilities:]Sewer Septic Building Height:
OWNER/LESS,EE CONTRACTOR
3
Name Wallace&Jerilyn Cooley Name: Richie the Roofer&Co Inc
Address:2220 Jennigan Rd Company:
City: Fort Pierce State:Fl Address: 6704 Santa Clara Blvd
Zip Code: 34945 Fax: City: Fort Pierce F State:FL
Phone No. Zip Code: 34951 Fax:
E-Mail: Phone No. 772-473-6197
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: ccc 058021
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRl TION LIE4N 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-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
ature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF `
The forg ing instr was acknowledged before me The for ing instru was acknowledged before me
this day of 20 lin this 57day of 20 �by
I �Jd i_(�'C L n YnI
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State7 of Florida) / (Signature of Notary ublic-State of Florida)
Personally Known OR Proc entification + Personally Known OR Prod�u�Identification ✓
Type of Identification Produced T of Identification Produced�'� /�0�Al
�, AREN S. NIELS N
Commission No. °.;� fission No.
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�_ ,.,o•'PY EN S. NIEL�IE
�qo�c' My Commission Expi'es - Commission #N
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June 1 2, 2 018 1 8
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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