HomeMy WebLinkAboutBuilding Permit Application '. i
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: ZS ! Permit Number:
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4111111111
LW-01-0 164 Nis
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: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION: i ."
114 N LAS OLAS DR
Address: li
Legal Description: SEE DETAILED DESCRIPTION OF WORK FOR THE LEGAL DESCRIPTION
Property Tax ID#: 4511-500-0017-000-8 Lot No.
Site Plan Name: Block No.
Project Name: SHINGLE REROOF JAN
Setbacks Front Back: Right Side: Left Side:
.DETAILED,DESCRIPTION.OF WORK ,
Shingle to Shingle REROOF with plywood decking
BEACH CLUB COLONY-SECTION ONE THAT PART OF LOT 8 MPDAF: FROM SE COR OF LOT 8 RUN N 46 28 11 E ALG E LI 130.81 FT TO NE COR OF LOT 8, TH N 23 49 31 W
42 FT TO N LI OF LOT 8, TH S 89 53 49 W ALG N LI 60 FT & POB, TH S 15 57 19 W 45.72 FT, TH S 20 47 56 W 36.80 FT, TH S 32 09 15 W 35.23 FT TO N R/W LI
OF LAS OLAS DR S CURVE CONC S, R OF 105 FT, TH WLY ALG ARC 34.05 FT TO SW COR OF LOT 8, TH NELY ALG W LI OF LOT 6 98.47 FT TO N LI OF LOT 8, TH N 89
53 49 E ALG N LI 60 FT TO POB (OR 2302-2400; 2304-29: 2855-946)
CONSTRUCTION INFORMATION
Additional work to be nerformed under this permit—check a appy:
HVAC L__I Gas Tank E]Gas Piping _Shutters -a Windows/Doors
Electric ❑Plumbing Sprinklers Generator l i�Roof Roof pitch
Total Sq. Ft of Construction: 2500 Sq. Ft.of First Floor: I
Cost of.Construction:$ 5000 Utilities: L!Sewer 0Septic Building Height: 11'
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,.OWNER/LESSEE:'., CONTRACTOR: ° (
Name Jan Dalcorso,MGM of TLC Rehab LLC Name: Danny Tomici
Address:114 N Las Olas Dr Company: The RoofSrriith
City: Jensen Beach State:F1 Address: 612 N Orange Ave A2
Zip Code: 34957 Fax: City:' Jupiter State:FL
Phone No.772-287-6885 Zip Code: 33458 , Fax:
E-Mail:jandalco@aol.com Phone No. 561.386.2109
Fill in fee simple Title Holder on next page(if different E-Mail: Danny@TheRoofSmithFL.com
from the Owner listed above) State or County License: CCC1327247
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAWINFORMAT101V
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address:612 N 0-nge Ave A2 Address:
City: State: F1 City: State: F1
Zip: Phone i Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do,the work and installation as indicated.
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 covenaritsithat 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. ,
Signature of Owner/Lessee/Contractor as Agent for Owner Signa re oto ont for/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Mann COUNTY OF le 'a—
The forgoing instrument was acknowledged before me The forgoing instrume t was acknowledged before me
this 10 day of August 1 ,20 by this Joday of 20a by
s-
Name o p s making s a ement Name of perso aking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Id'enti . ti
Produced 1.4114
Produced �7
i
(Signa re o Notary Public-Sate of FI ire=}' "-` Nota u is a orida)
y A BESINIE6 .LLAPUR * * State of Florida.
Commission No� 4 e Notary Public,S ;Allgr.46n o. y, CoQ lllly on EXpires03111j2018
Commissio N FF 928444 �¢� Comni4on WFF 100532
My comm.expi es Oct.18,2019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17