HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �` 51 �� Permit Number:
RECER"7-D JUN 15 2016 .
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 YES
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 7203 Lakeland Blvd Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 10-BLK!123 LOT 29(MAP 13/01S)(OR 533-396:UNREC AA DATED 2-29-88 IN FILE)
Property Tax ID#: 1301-612-0139-000-9 Lot No.
Site Plan Name: - Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
ReRoof Tear Off old shingles., Install new shingle roof
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
❑HVAC EiGasTank ❑Gas Piping _Shutters Q Windows/Doors
❑Electric ❑ Plumbing OSprinklers ❑Generator W1 Roof
Total Sq. Ft of Construction: 2100 S . Ft.of First Floor: 1512
Cost of Construction:$ 7350.00 Utilities:li Sewer❑Septic Building Height: 14 ft
OWNER/LESSEE: CONTRACTOR:
Name Name: John Durham
Address�% Lg L61 1e. ". -1 l.,-/ . Company: Durham Brothers Inc.
City: • Fj'8ACe State: L Address: 15897 62nd PI. N.
Zip Code: ,3�q.�/ Fax: City: Loxahatchee State:FL
Phone No. �161— /.2XI Zip Code: 33470 Fax:
E-Mail: NLN 7a-o-? C AoL , '(ern Phone No. 561.315.1835
Fill in fee simple Title Holder on next.page(if different E-Mail:
from the Owner listed above) State or County License: CCC1326757
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL 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-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
_Signature of Owner/Lessee/Agent -re—ofZA
tuContractor/License Holder
STATE OF FLORIDA TE OF FLORIDA
COUNTY OF ,P-.l -t Cf e_, c_! COUNTY OF 7,/,, !3r y
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this k day of J�v. 20��by this�(A day of _)u N e .20 l�by
(Name of person acknowledging) (Name of person acknowledging)
igc�a�e of Notary Public-State of Florida) Nna�e of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known O roduced Identification
Type of Identification Produce "tet -� e Type of Identification Produc
-ot Public State of Florida mmission No. —a
Commission No. — (Mot
Cevallos aQ N_�C Stare
y �9Q My Commission EE 219140 °�cu��' MYC mmvallo S of Flo nda
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
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