HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
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: Roof
PROPOSED-IMPROVEMENT LOCATION: -
Address: 6304 Emerson Ave Ft. Pierce, FI 34951
Legal Description: Lakewood.Park ,unit 8A,Blk 5Lot 6
Property Tax ID#: 1301-609-0050-000-1 Lot No.6
Site Plan Name: Lakewood Park Block No. 5
Project Name: O'Dell
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Rero/of �( (Z (7c�G� f2.e gra t fk, C��r®�P��c eaea f
115 pha f!,� S•kAV to
CONSTRUCTION INFORMATION: s
Additional work toa nertormed under this permit—check all that appy:
❑HVAC 0 Gas Tank ocas Piping Shutters oWindows/Doors
CGenerator
O
Electric Plumbing Sprinklers - Roof IZ Roof pitch
Total Sq. Ft of Construction: 41DO S . Ft. of First Floor:
Cost of Construction:$ l 11210 Utilities: Sewer ElSeptic Building Height:
OWNER/LESSEE: CONTRACTOR: I
Name merO'DellName: oger Facemire
Address:6304
Emerson Ave Company: Stratus Rooting,
City: Ft. Pierce State:_ Address: Oakland ve
Zip Code: 34951 Fax: City: Oakland State:
Phone No. Zip Code: Fax: - 14-15b-2_
E-Mail: Phone No. 407-625-5866
Fill in fee simple Title Holder on next page(if different E-Mail: office Q0 s ra usroo Ing.com
from the Owner listed above) State or County License: CCC
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: d
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 rk or recording our Notice of Commencement.
J
Vv r s
Sl&atuYe of Owner/Lessee/Contractor as Agent for Owner SlAnatVe of Contractor/License Holder
STATE OF FLORIDA STATE OF FLO DA
COUNTY OFA ►J c,-C COUNTY OF Ax)B1 L5
The forgoing instrument was acknowledged before me Theforgoing instrument was;acknowledged before me
this day of�e-� 20 I b by this 1� day d eC_ 20 Ii by
'rl FrF A-Q J L05-0 �i F R A?'J-[ Lu`3',0
(Name of person acknowledging) (Name of per sonwledging)
W J) _XIA 1,\. ack o
(Signaturl 01 N a Public-State of Florida) (Signa o No Public-State of Florida )
Personally Known—:4==_OR Produced Identification Personally Known, •OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. AP ®�®
' Commission No. � ��I• �;iF L (Seal) )
Tli"FA
r; MY COMMISSION#FF 197566
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February,09.2019 :. . - LLM, .�• .. .. " ,
' 'j f kai 1�NotaySewice.con MY COMMISSION Revised 07/15 � .�.
;g;�•,io? EXPIRES February 09.2011•
i4C• ,•tgg- '53 rWENNot ySe:vice.con-
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS _T