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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 9f21/17 Permit Number: I-Oct 103Z141
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 I ' PR01/EMENT LOCATIO'N
;
Address: 8282 Sand pine Circle Port Saint Lucie FI 34952
Legal Description:
LAKE LUCIE ESTATES PLAT NO. ONE LOT32(OR 2380-2917;3642-121)
Property Tax ID#: 3426-703-0046-000-9 Lot No.
Site Plan Name: One Block No.
Project Name: One
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK
Remove exirting roof coverage (shingle)
Install tri-built peel and stick for underlyment
Install 1" nail strip
CONSTRUCTION INFORMATION
Additionalwork to be nertormed under this permit—check all t=appy:
LJHVAC Gas Tank Das Piping _Shutters ❑Windows/Doors
Electric 0 Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: 2500 S . Ft.of First Floor: 2500
Cost of Construction:$ 16,500 UtilitiesSewer Septic Building Height: 8
OWNER/LESSEE CONTRAGTOR�i j
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NarneGEORGE ROWE Name: Mauricio Orellana
Address:8282 sand Pine Circle Company: One Construction&Roofing contractors
City: Port saint Lucie State:Fl Address: 2766 sw Edgarce st,
Zip Code: 34953 Fax: City: Port saint Lucie State: FI
Phone No.610-299-4626 Zip Code: 34953 Fax: N/A
E-Mail:gr0948@att.net Phone No. 772-519-2449
Fill in fee simple Title Holder on next page(if different E-Mail: oneconstructionserivices@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.
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SUPPLEMENTAL CQNSTRSIJCTION LIEN LAW INFORMATION
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DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:GEORGE ROWE N a m e:Mauddo Orellana
Address:8282 Sanfd pine Circle Port Saint Lucie FI 34952 Address: 8282 sand Pine Circle
City: PortsalntLucle State: City: PortsalntLude State:
.Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2766-Edgarce at 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 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
commencingwork or recordingour Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI �r STATE OF FLORIDA
COUNTY OF COUNTY OF J� lyct e
The forgoing instr�mAent was acknowledged before me The for oing instrument was acknowledged before me
this '2\ day of Pe .20 — by this ay of S -eP 20Aq by
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 Ident'cationf C
Produced--9(— L Produced LA, L
(Signature of Nota Pyu (Signature of Nota P> liS St e`8f� crida) �� L=r?
e 1 � ��G�9P�ii„aiGP:fir` F92517i I
Commission No. = Z 1 ;; �F.,25 1 IBES eF•S E�;57,
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17