HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 7
Date: a.�3 Permit Number: I1 I os l
•
Building Permit Application )3(5 R)R'77
Planning and Development Services XMi
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof - SIT\',
h
PROPOSED IMPROVEMENT LOCATION:
Address: C' l c-,Te, v t e FY
Legal Description: THE PRESERVE AT SAVANNA CLUB BLK 51 LOT 18(OR 1815-1235)
Property Tax ID#: 3425-706-0256-000-0 Lot No.18
Site Plan Name: Block No. 51
Project Name: (�
Setbacks Front ►J (la Back: U Right Side: 4�Left Side: P<
DETAILED DESCRIPTION OF WORK:
QeeA S- kart
Vo a. �Z� ski <k kAS
CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit—check all appy:
HVAC Gas Tank 0Gas Piping Shutters ❑Windows/Doors
❑Electric ❑_Plumbing Sprinklers ❑Generator Roof (Z Roof pitch
Total Sq. Ft of Construction: 7_834 Sq. Ft. of First Floor: ZF 3 q .I
Cost of Construction:$ �Q Utilities: ZSewer []Septic Building Height: 8
OWNER/LESSEE: CONTRACTOR:
Name u u n Name: u r c c, O 6re �-
Address: g7_ 0 �fit� ,%1 �� Company: ONE CONSTRUCTION&ROOFING CONTRACTORS
City: YbrT f r u L State: Address: Z 4'6 6 UJ �d Cwt/ C c= 57-
Zip
rZip Code: 3 S Fax:--- City: 2brr State:FL
Phone No.3Z S Zip Code: 34953 Fax: 844-270-3756
E-Mail: 0 I1�- 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 FL
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 HOLDE _ 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA _
COUNTY OF �'_', 1���L��=s COUNTY OF
The forg�g instrument was acknowledged before me The forpping instrument was acknowledged before me
this c 0 day of Nin sCtr—w0AI-fay this alR!7day of 1yO -k 20��f by
\��-s���� �C Q��c�y-sem �u`c��-\a ��C���®�►�.c�
Name of person making statement Name of person making statement
Personally Known C OR Produced Identification Personally Known l�— OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signa ure of Notary Public-State f of Notary Public-Stat FI ri
q .,t;m PAULETTE GLAIR- LFEFrXx•ANDER �l ;o:,ji�P� �AULETTE GLAIR-AL X DER '
Commission No. ` �r° , c Notary Public-Sta eb� �ids n No. ,_, t a I
•- r Notary Public-State f oridl
Commission#F 995699
"s"� Commission #FF 9 99
%.;�`oc« `'•` My Comm.Expires ep 6,2020 ';lF ,•�
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURT E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17