HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6-10-2016 Permit Number:
s _ J . _.
LW
s
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3498.2
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8306 Penny Lane Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK -UNIT S- BLK 94 LOT4 (MAP 13/02N) (OR 697-1045)
Property Tax ID #: 1301-608-0165-000-7
Site Plan Name: Coyne
Project Name: Coyne
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK
Right Side: Left Side:
Lot No.
Block No.
Tear off existing shingle roof install new shingle roof with a peel and stick underlayment on a 4/12
roof pitch.
Additional work to U(ertormed under this permit — cneck all tnat apply;
HVAC i =i Gas TankGas Piping _Shutters 11 Windows/Doors
Electric Plumbing Sprinklers F]Generator 121 Roof
Total Sq. Ft of Construction: 800 Sq. Ft. of First Floor:
Cost of Construction: $ 2470.00 Utilities: Sewer E]Septic Building Height: 24'
OWNER/LESSEE:
CONTRACTOR:
Name Kenneth Eden
Name: Richard A. Newland
Address: 8306 Penny Ln Fort Pierce, FL 34951
City: Fort Pierce, State: F:
Zip Code: 34951 Fax:
Phone No. 359-3794
Company: Richie the Roofer
Address: 6704 Santa Clara Blvd
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 866-610-8652
Phone No. 772-464-4329
E -Mail:
Fill in fee simple Title Halder on next page ( if different
from the Owner listed above)
E -Mail. richieroofera@yahoo.com
State or County License: 20506
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
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 your Notice of Commencement.
ignature of Owner/ Lessee/Agent ure of Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA_
COUNTY OF Li "___ ► C COUNTY OF -rte / L. C4 c
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of -/ c l•? ( 20 by this day of J C.i•E 2 20 /4' by
(Name of person acknowledging) (Name of person acknowl dging )
C-1
(Signature of Notary''�'uu liic- State of Florida) (Signature of NoteK Public- State of Florida )
Perso
Commission No.
OR Produced I
Produceld
Revised 07/15/2014
4scoLEWRriown OR Produced Identification
Type o enti _cation Produced r_
Fly CohirSISSiON #EE883700
(Sg*RES:I4iFR13,2017 Commission No.
Banded '-,.,q!!
MISTY BOBIUN
S�fd�-Q�/�tWIMISSION #EE883700
EXPIRES: MAR 13, 2017
Bonded 'r :`3ugh 1st State Insumce
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS