HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I I 17, Permit Number: / /- or/ �.0
L R �
-
Planning and Development Services Building Permit Application
NOV 2 2017
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 IMPRQI%EMENT LOCATIdN 3'
a
Address: 8653 Shadylake Ln. Fort Pierce FL 34947
Legal Description:
TIMBERLAKE ESTATES LOT 15
Property Tax ID#: 2302-601-0019-000-4 Lot No. 15
Site Plan Name: 8653 SHADYLAKE LN. Block No.
Project Name: SHINGLE TO SHINGLE
Setbacks Front Back: Right Side: Left Side:
14
DETAILED DES' RIPTtON O WORK
RE ROOF SHINGLE TO SHINGLE
x
E;
C{3NS1RUCTIOt INFORMgTION x
Yf+:F sy
Additional work toe e orme under this permit—check a appy:
E1HVAC �_Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers E Generator Roof 6:12 Roof pitch
Total Sq. Ft of Construction: 3,500 S . Ft.of First Floor:
Cost of Construction:$ 13,150 UtilitiestSewer Septic Building Height:
01�UNERCESSE3' aCONTRACTORa
Name EDWARD ANDERSON Name: Javier Solis
Address: 8653 SHADYLAKE LN. Company: SOUS ROOFING CONTRACTORS INC.
City: Fort Pierce State:FL Address: 1033 SW Dalton Ave
Zip Code:X4947 Fax: City: Port St. Lucie State:FL
Phone No. Zip Code: 34953 Fax: 772-8784097
E-Mail: ed@edanderson.us Phone No. 561-662-6622
Fill in fee simple Title Holder on next page (if different E-Mail: SOLISROOFINGINC@GMAIL.COM
from the Owner listed above) State or County License: CCC1330147
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
A 0"
Sl1 LES � ,E" C?NSTRyUCTENI.A INxb
e. ",� �.«
� � -
DESIGN ER/ENGINEER: X Not Applicable MORTGAGE COMPANY: _x_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 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.
Signaure of wner/L sewcontractor as Agent for Owner Signature Contractor/License Holder
STATE OF FLF FL
COUNTY OF OR �t'?T l.0 COUNTSTATEOYOFORID!E7_�v/n
The f rgoing instrum nt y+as ack owledged before me The f r oing instrum nt as a knowledged before me
this�day of A�qiv� 20-7 by this day of v�1�? 20 17 by
= �r_J 5jn,l e ,tea t)��� ��J "s
Name of p rson making statement Name of person making statement
Personally Known L/ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Plic-State of Florida) (Signature of Notary 0 lic-State of Florida )
'►Ay Pue other Pu4
Commission No. �°:"'••�P* AI SAJANO Commission No. a * I�OMAFSION#FN081432
MY CO ON#FF 181432 ,�
EXPIRES:April 4,2019 s, EXPIRES:April 4,2019
OFF�° Bonded Thru Budget Notary Servhes "OF 10'x` Bonded Thru Budget 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