HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-10-2016 Permit Number:
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: 8005 Pacific Av.
Legal Description: LAKEWOOD PARK -UNIT 4- BLK 32 6EGAT NW COR BLK 32, RUN N 89 DEG 53MIN E 132.87 FT, TH SO DEG 07 MINE 100 FT,
TH S 41 DI=G 40 MIN W 35 FT, TH W 110 FT, TH N 126.14 FT TO POB (16) (MAP 13111 N) (OR 3865-1734)
Property Tax ID #: 1301-604-0124-350-4 Lot No.
Site Plan Name: Block No.
Project Name: Karnes
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tear off shingle roof replace with shingle roof
Roof is3200square ft on a 3.5112 roof pitch.
Owens corning shingles FL10674-R11 Peel and stick underlayment
--Additional work to be nertormed under this permit— cnecK all apply:
HVAC Gas Tank E]Gas Piping _ Shutters FlWindows/Doors
EElectric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: 3200 S Ft. of First Floor:
Cost of Construction: $ 12,700.00 Utilities In Sewer U Septic Building Height: 18
OWNER/LESSEE:
CONTRACTOR:
Name Philip w Karnes Charity M Karnes
Name: Richard A. Newland
Address: 8005 Pacific Av.
Company: Richie the Roofer
City: Fort Pierce, State: FL
Zip Code: 34951 Fax:
Phone No. 561-676-1940
Address: 6704 Santa Clara Blvd
City: Fort Pierce State: FL
Zip Code: 34951 Fax: 866-610-8652
Phone No. 772'-464-4329
E -Mail: pkarn114@gmai1.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E -Mail: richieroofer@yahoo.com
State or County License: 20506
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
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:
BONDING COMPANY: Not Applicable
Dame:
Address:
Address:
City:
City:
Zip: Rhone:
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 thepermit 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 inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF S'!
The forgoing instrument was acknowledged before me
this ff day of JLQUi?t n (-c , 20 Eby
ature of Contractor
STATE OF FLORIDA
COUNTY OF S [ &t i f
The forgoing instrument was acknowledged before me
this /�_ day of J IL(2 0---"12- 20 /4-- by
(Name of person acknowledging) (Name of person acknowledging)
" �J� 'Zf� 1i_'qJ �'
(Signature of Notary Pu tate of Florida )
Perso y t ow ---OR Produced Identificationa
Typ [cation Produced gTYg9gi:7
1'.SSION *EE383700
Commission No.(Stab= ; p;tAR 13, 2017
Bulled :; wrnh 1, s! Stale Imurance
Revised 07/15/2014
(Signature of N ublic- Sta a of Florida }
P r �na�R Pro uced Identification
Ty ed _
,1f.R�PGB4 ,
�`�Y�1`liSS1O[yEE8837oD
Commission No. � �( RES: MAR 13, 2017
-
_50 06d iststate lfisLIrance
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT
AFTER RECORDING -RETURN TO: SAINT LUCIE COUNTY
FILE # 4248115 11/1412016 01:49:46 PM
OR BOOK 3932 PAGE 614 - 614 Doc Type: NC
RECORDING: $10.00
PERMIT NUMBER.
NOTICE OF COMAMNCEMENT — The undersigned hereby given notice that improvement will be made to certain real property, and in accordance with Chapter 713,
Florida statutes the following information is provided in the Notice of commencement.
1. DESCRIPTION OF PROPERTY (Legal description and street address) TAX FOLIO NUMBER: 1301-604-0124-350-4
SUBDIVISION BLOCK TRACT LOT BLDG UNIT
LAKEWOOD PARK -UNIT 4- BLK 32 BEGAT NW COR ULK 32, RUN N 89 DEG 53MIN E 13287 FT, TH 80 DEG 07 MINE 100 FT, TH S 41 DEG 40 MIN W25 FT, TH W 110 FT, TH N 125.14 FT TO POB (161 (MAP 13111N) (CR 3565.1734)
2. GENERAL DESCRIPTION OF IMPROVEMENT: Reroof
3. OWNER INFORMATION: a. Name Philip W Karnes
b. Address 8005 Pacific AVE Fort Pierce, FL 34951 e. interest in property owner
d. Name and address of fee simple titleholder (if other than owner)
4. CONTRACTOR'S NAME, ADDRESS AND Eir NUMBER: Richie the Rooter 6704 Santa Clara Blvd Ft Pierce FI. 34951
?� -?2 &19
5. SURETY'S NAME, ADDRESS AND PHONE NUMBER AND BOND AMOUNT:
6. LENDER'S NAME, ADDRESS AND PHONE NUMBER:
7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by
Section 713.13 (1)(a) 7., Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
8. In addition to himself or herself, Owner designates the following to receive a copy of the Lienor's Notice as provided in Section
713.13 (1)(b), Florida Statutes:
NAME, ADDRESS AND PHONE NUMBER:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date is
specified) .b[_i ,{&y44r _, VT 20_1�_-
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THEN TICE OF COMMENCEMENT
ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713 PART I SECTION 713.I3 FLORIDA STATUTES AND CAN RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
P Y-1 I -TF W. VhI f pr � c
Signature of Owner or Print Name and Provide Signatory's Title/Offiee
Owner's Authorized Officer/Director/Partner/Manager
State of Florida
County of St Lucie +�
The to M.
Ding instrument was acknowledged before me this � ar '� day of o [ e TfY .6 r 20�.
gy �` as owner
(Name of pers ) (Type of authority ... e_g. Owner, officer, trustee, attorney in fact)
F., self
(Name of party on behalf of whom instrument was executed) Personally Known x or produced the following type of ID: FL
NI�'�44r� RICHARD SNOOK
a*" o
=;o Gi'._NOTARY PUBLIC -STATE OF FLORMA
RV COMM. # EE647S27
(Printed Name of Notary Public) (Signature of Notary Public) Nr.,VV My COMM. EXPIRES 01-15-2017
Under penalties of perjury, I declare that I have read the foregoing and that the facts in it are true to the best of my knowledge and
belief (section 92.525, Florida Statutes).
Signature(s) of Owner(s) or Owner(s)' Authorized Officer/Director/Partner/Manager who signed above:
BY: � cc�—� O �u' ^y 2� By.
Rea,08/30/2007(Ree rdikq)
bed FW
= - .
L OR—
Planning F►.
& Development Services
Building & Code Regulation Division
2300 Virginia Avenue
Fort Pierce, FL 34982
772-462-2165 or 772-462-2172
Fax: 772-462-6443
ROOF INSPECTION AFFIDAVIT
Re: Permit
1, 1 "tut-CL'c°" L+ , licensed as a(n)Contractor*/Engineer/Architect
(Please print name & circle license type) *FS468 Building Inspector
General, Building, Residential or Roofing Can tractor or any individual certified under 463 F.S. to make such an inspection-
On
nspection
On or about _ �_ I did personally inspect the roof deck nailing
(Date)
(3 C5
work at: 4 c`A 112
(Job site address)
Based upon that examination I have determined the installation was done according to the Hurricane
Mitigation Retrofit Manual (Based on 553.844 F.S.)
Signature and Seal License #
STATE OF FLORIDA ,
COUNTY OF
Sworn t nd subscrib before me this l � day of 20L
by 3 Gt �: r X -e -V . Who is personally known to me or who has produced
as identifications.
Notary Public, state of Florida
Signature of Notary:1'_°
I
Commission Number: ���' °•� %�� (Seal)
En 01/19/2011
WA • MIS T f BOBILIN
WMy G()MF4ISSI0N *EF883700
EXPIRES: MAA 13, 2017
Bonded usrotmgh 1st Stale 1n6u ce