HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 01/15/2018
COC.IN7Y'
F L O R
Permit Number:
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 IMPROVEMENT LOCATION:
Address: 1721 Mallard Ct
Legal Description: North Fork Estates Lot 17
Property Tax ID #: 3409-503-0020-000-4 Lot No, 17
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Shingle Re -roof } p it-O&C)
CONSTRUCTION INFORMATION:
Additional work toe performed under t is permit— check a apply:
OHVAC Gas Tank Das Piping _ Shutters [] Windows/Doors
QElectric 0 Plumbing Sprinklers 11 Generator Z Roof ® Roof pitch
Total Sq. Ft of Construction: 4601�' SCI. Ft. of First Floor:
Cost of Construction: $ 13,630.34 Utilities: Sewer 0 Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Fenn and Carolyn Schott
Name: Francis Buchanan
Company: Buchanan Services,LLC
Address. 3300 SW 11th Street
Address: 1721 Mallard Ct
City: Ft. Pierce State: FL
Zip Code: 34982 Fax:
City: Deerfield Beach State: FL
Phone No. 772-284-4508
Zip Code: 33442 Fax:
E -Mail:
Phone No. 800-379-0122 ext 110
E -Mail: kelly@pdrhelps.com
Fill in fee simple Title Halder on next page (if different
from the Owner listed above)
State or County License: CCCO56685
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:
Zip: Phone
City: State:
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 your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA J� — STATE OF FLORIDA
COUNTY OF,COUNTY OF Martin
The forgoing instr ent was acknowledged before me
this day of Zo by
Name of perso making statement
Personally Known � OR Produced Identification
Type of Identification
Produced
The forgoing instrument was acknowledged before me
this 15th day of January , 20_ by
Name of person making statement
Personally Known x OR Produced Identification
Type of Identification
Produced
/' alz/ — - — f A " '/' - ": �2 L"� —.5-- w/�
(Signature of !Votary Public- S ate o i (Signature of Notary Public- State o y
j ! AREN F DIVA KAREN DI
Commission N."" r MM1SSIflN #GOO Commission No 14Y COMIAMSSION i
�a ' EXPIRES March
EXPIRES March 30.20 1
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
fq- / 1.5(,
JOSEPH E. SMITH, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4390928 OR BOOK 4087 PAGE 692, Recorded 01/16/2018 10:54:23 AM
NOTICE OF COMMENCEMENT
Permit No, Property Tax IDNo. 3409-503-0020-000-4
State of Florida, County of St. Lucie
The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
Legal Description of property and address if available NORTH FORK FSTATES SiD LOT 17 (0.50 AC) (OR 1354-2979.2717-1819)
1721 MALLARD CT Ft. Pierce, FL 34982
General description of improvements shingle re -roof
ownerllessee Kenn W and Carolyn Schott
Address 7721 Mallard Ct Fon Pleree, FL 34981
Interest in property: 1C0% owners
Fee Simple Title holder (if other than owner)
Address
Contractor Buchanan Services LLC
phone # 600-379-0122
Address 3300 SW 11th Street Deefeld Beach, FL 33442
Fax #
Surety
Phone #
Address
Fax #
Amount of Bond
Lender
Phone #
Address
Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13 (a) 7., Florida Statues:
Name
Phone #
Address
Fax #
In addition to himself, owner designates
Phone # Fax #
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (h), Florida Statutes. Expiration date of notice of
commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER:
ANY PAYMEN IS MADE. RY THE OWNER AkTFR THE EXPIRA IION OF THE NOTICE. OF COIv MENCE?MENT ARE CONSIDERED IMPROPER
PAYiMENTS UNDER CI [.713.13, F.S., .AND CAN RESULT IN YOUR PAYIN4i TWICE FOR IMPROVEMF.NI'S 1'D YUUR PROPER IN. A `OT10E OF
COhIMENCEMENT M111 -T HE RECORDED AND POSTED O.N THE JOB SITE BEFORETHE FIRST INSPECTION. IF YOU INTENDTO OBTAIN
FINANCING. CONSI11.7 WITH YOUR LEDER OR AN ATTORNEY SFFORF. CO LACING WORK OR RL•COMNG YOUR NOTICE Or
COMMENCME:N I. f
or Lessce's Authorized Orf:cerf0irecta r/Partner/Nfanagerl Signature
�egnarury's ituerumce
State of Florida, County of Martin
Acknowledged before me this �j' day of %rlh�°ti 20 1'9 , by 4,
whops personally known to me or who has produced Z _ _ as identification.
�
Signature of Notary Type or Print (Name of ]Notary
KAREN E DEV
Title: Not�ary Public Commission Number ��yiQ �����-/ ;� �;�.
my COMWSSION
A7
GG098819
'a EXPIRES March 30.2021
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