HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d C�
Date: -e- Permit Number:
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RECEI`
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION;
Address: 8200 Fort Pierce Blvd
Legal Description: Lakewood Park-unit 8-Blk 93 Lot 12
Property Tax ID#: 1301-608-0141-000-3 Lot No.12
Site Plan Name: Lakewood park Block No. 93
Project Name: Lenora Richardson
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF 1itibRK:
Remove and replace entire shingle roofo�e Shia�Sl Z�ss��L 1�0�� (SSS
LfLX Slate
12 Pi"
CONSTRUCTION]N FOR MATI ON.:
Additional work to be nerformed under this permit—c eck allt t appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E]Generator F,17 Roof
Total Sq. Ft of Construction: 2600 S . Ft.of First Floor: 1335
Cost of Construction:$ 8475.00 Utilities:Sewer E]Septic Building Height: 1 story
OWNER/LESSEE:. CONTRACTOR:,
Name Lenora Richardson Name: Richard Colletti
Address:2601 Kings Mill rd Company: LeakBusters Roof Repair
City: Greensboro State:NC Address: 6101 Buchanon Dr
Zip Code: 27407 Fax: Cit_y: Fort Pierce State:fl
Phone No. Zip Code: 34982 Fax:
I
E-Mail: Phfioone No. 7728018393
Fill in fee simple Title Holder on next page(if different E-Mail: jessebrewer422@gmail.com
from the Owner listed above) ;:.�; State or County License:
If value of construction is$2500 or,more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: 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,1 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 irlspection. If you intend to obtain financing, consult with lender or an attorney before
commencing wodk or recording our Notice of Commencement.
S
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIPP
COUNTY OF L uA,c COUNTY OF J1 L (�, C. �-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this.—L day of r-'1— 20 LLby this Z day of A LJ4 20 ) by
"` V _Z�t7
1 ✓ �Z&/
(Name of person acknowledging) (Name of person acknowledging)
(Signature of tary Public-State of Florida) (Signature of NoWy Public-State of Florida)
Personally Known /_ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. C Commission No. ""4'. CA(S f)BINKLEY
BINKLEY
'+P' = =• My COMMISSION#FF238333
MY COMMISSION#FF23833Z
EXEIRE
10
EXPIRES Augysl 16,2019 ,
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Revised 07/15/201 Iscn�sa.�°�w rlatYfANnwr S�rvlw c,Gr."
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