HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED II
Date:' �(p �oG Permit Number: I6ol-� o-d
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Building Permit Application FEB 2 4 2016
Planning and Development Services PERrAITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
P`ROPO.SED IMPR01/EMENT:,LOCATION
Address: 7806 PENNY LN
Legal Description: LAKEWOOD PARK-UNIT 7-BILK 86 LOT7(MAP 13/02N)(OR 3404-232)
Property Tax ID#: 1301-607-0366-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Walters
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:,
Tear off existing shingle roof install shingle roof and 300 square ft of flat roof
I12_ �Ca�
1C0N$TRUCTI`ON INFORMATION- '
Additional work to be performed under this permit—check all t=appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Z Roof
Total Sq. Ft of Construction: 1600 SFt.of First Floor:
Cost of Construction:$ 8223.50 Utilities:)Sewer 0Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name Ralph Walters Name: Richie the roofer
Address:3108 Lost Tree Ln Company:
City: Fort Pierce State:FL Address: 6704 Santa Clara Blvd
Zip Code: 34982 Fax: City: Fort Pierce State:FI
Phone No.772-528-1553 Zip Code: 34951 Fax:
E-Mail: Phone No. 72 Z y7 3 oll4 7
Fill in fee simple Title Holder on next page{if different E-Mail:
from the Owner listed above) State or County License: 20506
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIfON:
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
Si ature of Owner/Lessee/Agentature of Contractor/License Holder
STATE OF FLORIDAt STATE OF FLORIDA
COUNTY OF l._tCOUNTY OF 14 LU CIT,
The fRS�r ing instru t was acknowledged before me The forg ing instrum was acknowledged before me
this o� day of 20 �y this,-"-)V of20 by
(Name of person acknowledging) (Name of person acknowledging)
L__ ��- L,
1_�� I I Q5,Ncr,
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida) /
Personally Known OR Prod ced Identification I✓ Personally Known OR Produced Identification
Type of Identification Produced L, r ,) Type of Identification Produced L. n•f,
Commission No.
ission No. Fr_ r 119
tiAREN S, `"�"""•
NIELSEN ,;o:�^• KAREN S. NIELSEN
*_ Commission # FF 11 637 =• Commis
�O;011" Y Commission Expires �9fFOFclO�4,,, MY Commission Expires
Revised 07/15/2014 June 12, 2018 °��,,,,,����`' June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS