HomeMy WebLinkAboutBuilding Permit Application I „
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / -5-�'7 Permit Number: no
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Building Permit Application
Planning and Development Services
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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
�PROPQSED IIVIwPROVEMENTLOCATION '_ r r
Address: 6100 Deborah Way Fort Pierce, FL 34951
Legal Description: LAKEWOOD PARK-UNIT 5- BLK 52 LOT12 (MAP 13/02S) (OR11396-1033: 1486-1614)
Property Tax ID#: 1301-605-0278-000-3 j Lot No. 12
Site Plan Name: Block No. 52
Project Name:
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Setbacks Front Back: Right Side: Left Side:
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64.
'40ETAILED�DESCRIPTION OF�U1%ORK
tear off existing roof and install new shingle roof
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COIVSTRUCTIONINFORMATION ' Yr
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Additional work toe e orme under this permit—check a appy:
HVAC E] Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers El Generator' [ I Roof `1 /� Roof pitch
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Total Sq. Ft of Construction: -3O 00 Sq. Ft. of First Floor:
Cost of Construction:$ 93,10 OO Utilities: Ll_Sewer❑_Septic Building Height: s�ar
OWNER%LESSEE M :CONTRACTOR: ,,
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Name Karen S Blackburn Name: CHARLESRICHARDS
Address:6100 Deborah Way Company: ALL AREA ROOFING
City: FORT PIERCE State:FL Address: 3921 SjUS HWY 1
Zip Code: 34951 Fax- City: FORT PIERCE State:FL
Phone No.7729716922 Zip Code: 349821 Fax: 7724646600
E-Mail: Phone No. 7724646800
Fill in fee simple Title Holder on next page(if different E-Mail: JENNIFER@ALL'AREAROOFING.COM
from the Owner listed above) State or County License: CCC1326177
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is iequired.
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W7177
Ckm} 5 CYC Sri 9 e��k 1' �
SYUENT'AL CONSTRUCTION LALIEN W INFORMi4Tl0 1 �.,.. .a?-'�;".�a Aam,•,._.-.. .P '-�«..�_,� �..�'�,�3;F ;r � .�.4�4?.cr, ;2}w'•.4,5 �. � � -, z.:;n s;;.. .. .ter Y.
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 Horne 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:lroom 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
commerIcing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contra ctor/Licen'se Halder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COUNTY OF ST.LUCIE
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The for oing instr ent was acknowledged before me The forgoing instrument was,acknowl edged before me
this day of�� 20 Lby this s day of JANUARY y 20 /� by
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CHARLES RICHADS CHARLES RICHARDS
(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known i OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. °tT,«P.tal) FAtTHMASON Commission No. � yF (Seal)
* #•MY COMMISSION#GG 003V9 i -* .....,.li0 FAO H MASON
wr a EXpiRE i - *' * MY COMMISSION#GG 003939
_0040V° 00*4"111 Oulfys!NWM S,,W, EXPIRES:June 20,2i 0
Revised 07/15/2014 'aOFF�°� Thmsl*mNowrySsMces
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION' SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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COMPLETE
INITIALS