HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d
Date: May 19,2016 Permit Number: I ns- r ass
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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 x
PERMIT APPLICATION FOR: Roof
PROPOSED P OSED IMPR,OV.EME�NT LOCATION
Address: 8004 Ft Walton Ave, Ft Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 6-BLK 63 LOT2(MAP 13/02S)(OR 929-1950)
Property Tax ID#: 1301-606-0110-000-1 Lot No.2
Site Plan Name: LAKEWOOD PARK Block No. 63
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCR'IPTION'COF WORK
Remove old roofing material and install nails to Miami Dade code and apply polyglass IRX peel and
stick, install Owen Corning Dimension shingle.
CONSTRUCTION,INFORMATION
Additional work to be nerformed under this permit-check all apply:
HVAC Gas Tank Gas Piping _Shutters Windows Doors
11 Electric 0 Plumbing Sprinklers ❑Generator g Roof
Total Sq. Ft of Construction: 3200 sq ft SFt.of First Floor:
Cost of Construction:$ 12,000 Utilities:n Sewer Septic Building Height:
OWNER/LESSEE;' CONTRACTOR:
Name Susan Garman Name: Jim Underwood
Address:8004 Ft Walton Ave Company: Jim Underwood Roofing,"_-
City: Ft Pierce State:FL Address: 1150 Gulfport Rd Se
Zip Code: 34951 Fax: City: Palm Bay " State:FL
Phone No.772-971-4031 Zip Code: 32909-5000 Fax:
E-Mail:susangarman@gmaii.com Phone No. 321-726-6628
Fill in fee simple Title Holder on next page(if different E-Mail: shaneboykin69@icloud.com
from the Owner listed above) State or County License: CCC1325827, 1325827
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION UEN-LAW INFORMATION;°
DESIGNER/ENGINEER: X_Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: East Coast Mortgage Lenders
Address: Address: 3228 SW Martin Downs Blvd
City: State: City: Palm City State: FL
Zip: Phone: Zip: 34990 Phone.
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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.
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_Signature of Owne'r7 Lessee/Agent Signat o Contractor/License Holder
STATE OF FLORIDA STA OF FLORIDA
COUNTY OF S'r. Lv LI COUNTY OF 1
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this2 O day of AA P,�4 20 Icy this_;;6_day of Y�fN 20 _LL by
SUs�t� A�MA� �lh� Uri belwcr6�
(Name of person acknowledging) (Name of person acknowledging)
(Signatu a of ary P blic--St'kelof Florida) (Signature of Notary P lic-State of Florida
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ersonall Known OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Produced (:L bRtv&e ( I C w Se Type of Identifi :ocq u6�
oti.. re•,
;.: .. Commission#FF 1,1.561
Commission No. FF 14 2 g 14 IJ: ea6HRISTOPHER J.FRY LLF'bmmission No May 21,2"661)
NOTARY PUBLIC ''�,o"b"o_ aondedThruTroyFanlnsurance800385-7019
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Revised 07/15/2014 INCE W Expires 7/17/2018
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