HomeMy WebLinkAboutBuilding Permit Application a
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9/15/17 Permit Number: n a
RECEI�►ELD SEP 15 2017
me Sm
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: 8288 SANDPINE CIRCLE PORT SAINT,LUCIE FL 34984
Legal Description: LAKE LUCIE ESTATES PLAT No.ONE LOT 35(OR 2351-957)
Property Tax ID#: 3426-703-0049-000-0 Lot No. 35
Site Plan Name: PINE Block No.
Project Name: PINE
Setbacks Front Back: Right Side: Left Side:
77 I
DETAILED DESCRIPTION`.OF WORK p
Remove and replace exiting roof shingle
Install peel & stick tri-build undelaynment
CONSTRUCTION INFORMATION
Additional work to be nertormed under this permit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers Generator R1 Roof ® Roof pitch
Total Sq. Ft of Construction: 2036 S . Ft. of First Floor: 3268
Cost of Construction:$ 15,000 Utilities: Sewer Septic Building Height: 8
OWNER/LESSEE CONTRACTOR.
Name PAUL E RALSTON Name: MAURICIO ORELLANA
Address: 8288 SANDPINE CIRCLE Company: One Construction&roofing contractors
City: PORT SAINT LUCIE State: FL Address: 2766 SW EDGARCE ST
Zip Code: 34952 Fax: N/A City: PORT SAINT LUCIE State: FL
Phone No.772-768-5834 Zip Code: 34953 Fax: N/A
E-IVlail:NIA Phone No. 772-519-2449
Fill in fee simple Title Holder on next page(if different E-Mail: oneconstructionservices@yahoo.com
from the Owner listed above) State or County License: CCC-1330623
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
"SUPPLEMENTAL.CONSTRUCTCON"LtEN'LAW INFORMATION
DESIGNER/ENGINEER: x Not Appli le MORTGAGE COMPANY: _Not Applicable
Name: PAUL E RALSTON Name:MAURICIO ORELLANA
Address:8288 SANDPINE CIRCLE PORT SAINT LUCI 34984 Address: 8288 SANDPINE CIRCLE
City: PORT SAINT LUCIE State: City: PORT SAINT LUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE DER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Z Name:
Acddress:2766 EDGARCEST Address:
City: X 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 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST-.. COUNTY OF-LU.Ir
The forgoing instrument w s acknowledged before me The forgoing instru e t was acknowledged before me
this day of S Q 20 ('1 by this I'S day of f20�11 by
avVIC;D e00"(. Lo')v I CID ON,C�1��+-1�
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced < �• Produced 1
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(Signat re of Notary Pu lic-5tate.of Fleuda (Signature of Notary Public-Stat f-Hod&4—
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Commission No. ��� .°•�� <; ��br��nl�slOr�n FF92',? 4` mission No. �`'.. »(51eall)IJVIISSION 4 FF9251 d
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" 1,, 19 I EXPIRES�tecerrtb4r 17,2 1
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EXPIRES December 2
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17