HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-17-2016 Permit Number: p
Ira
•
Building Permit Application DEC 0 9 2016
PERMITTING
Planning and Development Services St. Lucie County, FL
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 y
Address: 8005 Pacific Ave
Legal Description: LAKEWOOD PARK-UNIT 4-BLK 32 BEGAT NW COR BLK 32,RUN N 89 DEG 53MIN E 132.87 FT,TH SO DEG 07 MINE 100 FT,TH S 41
DEG 40 MIN W 35 FT,TH W 110 FT,TH N 126.14 FT TO POB(16) (MAP 13/11 N)(OR 3865-1734)
Property Tax ID#: 1301-604-0124-350-4 Lot No.
Site Plan Name: Karnes Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION-.OF
Install a Polyglass roof system on flat roof of home. SEE Engineering
forgot flat roof on main roof permit
CONSTRUCT.{ON.INFORMATION „
: . _ .
Additional work toe performed under this permit—check a appy:
HVAC 13 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers E Generator FV(] Roof
Total Sq. Ft of Construction: 400 S .Ft.of First Floor:
Cost of Construction:$ 1850.00 Utilities:]Sewer Septic Building Height: 9'
01NNER/LESSEE fCONTRACTOR. .t
Name Philip Karnes Charity Karnes Name: Richard A. Newland
Address:8005 Pacific Ave Company: Richie the Roofer
City: Fort Pierce, State:FIL 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 LAW INFORMATION:'
J
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 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,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 ' ignature of Contractor/License-Ho er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 4' .")0 ,1 E, COUNTY OF Lk. L 00,1
The forgoing instrument was acknowledged before me The f rgoing instrument was acknowledged before me
this_T day of �� 20�.by this day of�� 20 J*by
� � I � �G1-lr� I�/��✓UAw�11 cLl��.arc11 1���1+�1 `Pnn,,�A
(Name of person acknowledging) (Name of person acknowledging)
+ e9,
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification �1/ Personally Known OR Produced Identification
Type of Identification Produced VT b L. Type of Identification Produced EIL 'D-L
Commission No. (Seal) Commission No.KF— �l ' KAR43bifl) NIELSEN
=2 S Commission # FF 115637
My Commission Expires
une 12, 2u 16
3� �_ Commission# FF 115637
Revised 07/15/2014 sN� a My Commission Expires
June 12, 2018
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS