HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10/11/17 Permit Number: _
0s� s
RECEIVED
Building Permit Application OCT 1 6. 2097
Planning and Development Services
Building and Code Regulation Division PERMITTING
St. Lucie County, FL
2300 Virginia Aven,ue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: OCEAN RESORTS COOPERATIVE SITE 204 (OR 3095-1298)
Property Tax ID#: 1410-502-0204-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TEAR OFF EXISTING SHINGLE ROOF AND INSTALL NEW SHINGLE ROOF (MOBILE HOME)
CONSTRUCTION INFORMATION:
Additional work toe nertormed under tispermit-check all appy:
HVAC Gas Tank []Gas Piping _Shutters E]Windows/Doors
11 Electric ElPlumbing Sprinklers Generator Roof 312 Roof pitch
Total Sq. Ft of Construction: 1400 SFt. of First Floor:
Cost of Construction:$ 5200 Utilities:cn Sewer 0Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name fP' Name: (C:hcLr S
Address: rpa a W�e ki Company: t
City: -I �;>?,fOf, State: Address: l,{S
Zip Code: 2 H -I Ctq Fax: City: rj- 2rc 'L State:
Phone No. c� 15 t�o�g'Q.`19 D Zip Code: 3L{9g2� Fax: -7-7Q-I-Il al-I - Jalo 0�
E-Mail: Phone No. l_1 - Llko14- LPFs00 11
Fill in fee simple Title Holder on next page(if different E-Mail: bo-za rW Q. CD In
from the Owner listed above) State or ounty License: OCC- 13Q(0 lyn
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:
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 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording
our Notice of Commencement.
�M" &J
C?-,'� 6"
Signature of Owner/Lessee/Contractor a 1A ner Signature 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 11 day of OCTOBER 20 1—( by this 11 day Of OCTOBER ,2011 by
CHARLES RICHARDS CHARLES RICHARDS
Name of person making statement Name of person making statement
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Produ ed Produced
ature of Notary Public-State of Florida) ( ure o Notary Public-State of Florida)
�d�;puk FAITH MASON otgo Pu"" FAITH MASON
Commission No. MYCOj )ON#00003939 Commission No. _ ' °S
* 8OMMISSION#GG 003 9
s \ae EXPIRES:June 20,2020 _10R,110-
n, EXPIRES:June 20,2020
SOF F10� Bonded Thor Budget Notary BeMm 0 F,110 Sodded Thor Budget Notary Se
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17