HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5/10/17 Permit Number: 125- 0 2-2-3
Law
Building Permit Application MAY 10 2@17
Planning and Development Services
PER.MITTi�,C Building and Code Regulation Division St. Lucie Cot:nty, 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 IMPROVEMENT LOCATION:
Address: 4910 EVERGREEN AVE FT PIERCE, FL 34947 r
Legal Description: HARMONY HEIGHTS BLK G LOTS 11 AND 12 (0.28 AC)(OR 360-1104)
2406-502-0123-000-1 11 & 12
Property Tax ID#. Lot No.
op y
Site Plan Name: Block No. G
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW SHINGLE ROOF
CONSTRUCTION INFORMATION:
Additional wor toe performed under tispermit—check all appy:
HVAC Gas Tank []Gas Piping Shutters ❑Windows/Doors
Electric E] Plumbing Sprinklers Generator Roof 412 Roof pitch
Total Sq. Ft of Construction: 2800 S . Ft.of First Floor:
Cost of Construction:$ 7700 Utilities:�Sewer Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name ALONZO ROLLE Name: CHARLES RICHARDS
Address:4910 EVERGREEN AVE Company: ALL AREA ROOFING
City: FT PIERCE State:FL Address: 3921 S US HWY 1
Zip Code: 34947 Fax: City: FT PIERCE State.FL
Phone No.772-465-8582 Zip Code: 34982 Fax: 772-464-6600
E-Mail: Phone No. 772-464-6800
Fill in fee simple Title Holder on next page(if different E-Mail: JENNIFER@ALLAREAROOFING.COM
from the Owner listed above) State or County License: CCC1326177
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
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 frst inspection. If you intend to obtain financing, consult with lender or an attorney before
commepcjbg work or recording o otice of Commencement.
s
Signature of Owner/Lessee/Contractor as Agent for Owner Si ature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY O F ST LUCIE COUNTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this ZQ day of /712 y 20/Zby this /6)day of fray 20 /-1 by
CHARLES RICHARDS CHARLES RICHARDS
(Name of person acknowledging) (Name of person acknowledging)
Ignature of Notary Public-State of Florida) (SigNftzdure of Notary Public-State of Florida)
Personally Known X OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 4RdP� (Seal) Commission No. �4 YpU,�o (SeaI�AITHMASON
FAITH MASON * * MY COMMISSION#GG 003939
N� c� : une 0,2020
� \oma EXPIRES:June 20,2020 �rFOF FLo�� Bonded Ttw Budget Notary Services
Revised 07/15/2014 'FOFF�O� Bonded Thru Budget Notary Servhs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS