HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11/1/17 Permit Number:
fs,�!]--. , RECEIVED
Building Permit Application NOV 12017
Planning and Development Services
Building and Code Regulation Division PermittingDepartment
2300 Virginia Avenue,Fort Pierce FL 34982 p
Phone: (772)462-1553 Fax: (772)462-1578 CommercialStR etQabhnty_; FI
_J
PERMIT APPLICATION FOR: Roof - sk��ngle
PROPOSED IMPROVEMENT LOCATION:
Address: Q,+ 5
Legal Description: SPANISH LAKES FAIRWAYS(6771 MAR PACIFICO CT FT PIERCE, FL 34951
Property Tax ID#: 1306-111-0001-000-0 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 performed under tispermit—check all appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing []Sprinklers Generator Roof 212 Roof pitch
Total Sq. Ft of Construction: 1`000 SFt.of First Floor:
Cost of Construction:$ 7410 Utilities:Sewer E Septic Building Height: 1 STORY
OWNER/LESSEE: CONTRACTOR:
Name ot Name:
Address: /ca�3 c�u�Q f' QP _.pf Company:
City: t-e.V State: Address: gal 5 tA_S
Zip Code: LA 335 Fax: City: c� C� State:FL
Phone No. (n I (o— ��9—35y 4 Zip Code: 3gggg 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:
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
commenc' ork or recording our N tice of Commencement.
Signabre'of Owner/Lessee/Contractor gent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST LUCIE COU NTY OF ST LUCIE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1 day of NOVEMBER 20J_7 by this 1 day of NOVEMBER ,2012 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
Prod ced Produced
Signature of Notary Public-State of Florida) (Signature of Notary Public- tate of Florida)
;"Ay?� �¢'�;�:Poai,�,
, FAITH MASON
QrFAITH MASON r
Commission No. al
COMMISSION#GG 00 939ommission No. * MISSION#GG 003939
a4 EXPIRES:June 20,202 oQ EXPIRES:June 20,2020
FLOC` Bonded Thru Budget Notary Se n
::'FF&9Q BondedThruBud®et Notary Services
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17