HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q
Date: 12-9-2016 Permit Number:
I n
- RECEIVED
Building Permit Application DEC 0 9 2016
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
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 1MpROVEMENT LOCATION
. .
Address: 015 RAc a 7 -20 (., L,.--rtA 5
Legal Description: LAKEWOOD PARK-UNIT 7-BLK 75 LOT14(MAP 13/02N)(OR 792-2936)
Property Tax ID#: 1301-607-0145-000-8 Lot No.
Site Plan Name:(6*P16& Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK "
Tear off existing shingle roof install peel and stick underlayment and Install a Drexel metal roof see
product approval
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CO`NSTR'UCTIONsI,N_FORMATION
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Additional l work to be performed under t is.permit-check all that appy:
HVAC Gas Tank r_1 Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator W1 Roof
Total Sq. Ft of Construction: 1800 Sq. Ft.of First Floor:
Cost of Construction:$ 8500.00 Utilities:11Sewer Septic Building Height: 9'
OWNER%LESSEE 4 ` ' CONfiRAC,TOR: y
Name John F Duran Name:- Richard A. Newland
Address: 7706 Citrus Park Blvd Fort Pierce, FL 34951 Company: Richie the Roofer
City: Fort Pierce, State:FL Address: 6704 Santa Clara Blvd
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.561-676-1940 Zip Code: 34951 Fax: 866-610-8652
E-Mail: Phone No. 772-464-4329
Fill in fee simple Title Holder on next page(if different E-Mail: richieroofer@yahoo.com
from the Owner listed above) State or County License: 20506
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN WIN -
K.
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
nature of Owner/Lessee/Agent ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5TIt� COUNTY OF 5%
The forgoing instrument was acknowledged before me The f going inst ment was acknowledged before me
this day of 20 1t, y this day of 20 by
1 ;..l a j11�-E:►„�� . C Gi A 14A JI Yti+Y
(Name of person acknowledging) (Name of person acknowledging)
-::;:L 1�-k 1-AA1
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(Signature of Notary Public-State of Florida) / (Signature of Notary Public-State of Florida)
Personally Known OR Prol coed Identification ✓ Personally Known OR Produced Identification
Type of Identification Produced 1� - 1�.L Type of Identification ProducedL_
Commission No. l l (Seal) Commission No. (Seal)
\\\111111//�
*_ Commission# FF 115637 Commission# FF 115637
Revised 07/15/201 0 My Commission Exp r o�c My Commission Expires
June 12, 201 ��'F0"`0�`` June 12. 2nip
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS