HomeMy WebLinkAboutBuilding Permit Application ie
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ALL APPLICABLE NrrFO M ST BE
COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: 1� Permit Number: Ux C
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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
PERMIT APPLICATION FOR: Roof
,P,RQP.OSED.IM,PROVEMENT LOCATION:,
Address: 7902 Holopaw Avenue Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK UNIT 5 BLK 46, LOT 8 (MAP 13/11 N) (OR 537-2491)
Property Tax ID#: 1301-605-0156-000-2 Lot No.8
Site Plan Name: Block No. 46
Project Name: MEDIATE RESIDENCE
Setbacks Front Back: Right Side: Left Side:
D`ETAfLED;DES"CRIPTION OF V1%ORK.;
Remove existing shingles and underlayments to wood deck. Repair deck as needed. Install OC
architectural shingles over 30#ASTM D-226 felt tin tagged. Install 401ft. ridge vent. Replace (1) B/C
self flashing skylight.
C'OIV,STRUCTI''ON INFORM'ATION.. a:
Additional work toeasel Orme under this permit-check a appy:
HVAC L_J Gas Tank ❑Gas Piping _Shutters a Windows/Doors
Electric 0 Plumbing Sprinklers E Generator W1 Roofl)2 j
Total Sq. Ft of Construction: 1,530 S�Ft.I of First Floor:
Cost of Construction:$ 6830.00 Utilities: L__I Sewer Septic Building Height: I
OV1/NER/LESSEE.'` ". CONTRACTOR:
Name,Joel A.Mediate&Vickie L Mediate Name: Brad S. Hogan
Address:7902 Holopaw Avenue Company: Cardinal Roofing &Siding Co. Inc.
City: Fort Pierce State:FL Address: 1601 SE South Niemeyer Circle
Zip Code: 34951 Fax: City: Port St. Lucie State:FL
Phone No.772-215-2895 Zip Code: 34952 Fax: 772-335-9554
E-Mail: Phone No. 772-335-9550 -
Fill in fee simple Title Holder on next page(if different E-Mail: j•davis@cardinalroofing.com
from the Owner listed above) - State or County License: CCC032513
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTR_U.CTION",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 ofi:Owner/Lessee% _ent Signature of Contractor/Licens older.
STATE OF FLORIDA / STATE OF FLORIDA
C
COUNTY OF Sf• om,• COUNTY OF
The forgoing instrume t was acknowledged before me The forgoing instrumen was acknowledged before me
this ZO day of 20/` by this ZO day of 201J_by
'8061- E, 90CAN t RAD S • 406AN
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary,Public-u -State of Florida) (Signature of Notary Public-State of Florida
Pu )
Personally Knowny OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identificg4n Produced
'�'%::;BG� BRUCE A.ROESSNER a°`;•••. o BRUCE A.ROESSNER
Commission No. MYCOMMISSION If al275 Commission My COMMISSION#FF21(ISAal)
EXPIRES:April 3,20 9 O„ EXPIRES:April 3,2019
�qr 10 Bonded Tin Budget Notary Services R of FL°�\� Bonded ThN BudgetNofary Serves
k
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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