HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1i11i1a Permit Number:
- _ _
RECEIVED
Building Permit Application
Planning and Development Services JAN 16 2018
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 ST. Lucie Coarlt hHPffiICC�R9
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof 5 h ) tic (',.
PROPOSED IMPROVEMENT LOCATION:
Address: 15 vera Cruz,Ft.Pierce,FL 34951
Legal Description:
Property Tax ID#: �3a - \�1- d ad 1— o b0—5 Lot No.
Site Plan Name: Block No.
Project Name: P108Tassone
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove current shingle roofing system, re-nail deck to code, install synthetic felt underlayment,and install new Architectural Shingle
roofing system.
CONSTRUCTION INFORMATION:
Additional work to b rtormed under t ispermit—check all appy:
HVAC Gas Tank F_]Gas Piping Shutters ❑Windows/Doors
❑Electric ❑ Plumbing Sprinklers ❑Generator Z Roof 2 Roof pitch
Total Sq. Ft of Construction: 1766 Sq. Ft. of First Floor: 1633
Cost of Construction: $ 6750 Utilities: Ri Sewer Septic Building Height: 1-Story
OWNER/LESSEE: CONTRACTOR:
Name Jerome Tassone Name: Christopher Dutruch
Address: 15 vera Cruz Company: MAC MAR, LLC/My Affordable Roof
City.. Ft. Pierce State:FL Address: 1585 Kennesaw Drive
Zip Code: 34951 Fax:nia City: Clermont State:FL
Phone No.772-464-2652 Zip Code: 34711 Fax: 772-905-8694
E-Mail: Phone No. 772-206-3344
Fill in fee simple Title Holder on next page(if different E-Mail: wendell@myaffordableroof.com
from the Owner listed above) State or County License: CCC#1331305
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 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 Signa ure of Contractor/License Ho/der
STATE OF FLORIDA / J_ r STATE OF FLORIDA
COUNTY OF VVV If) I us COUNTY OF
The f rgging instr ment was acknowledged-before me The fop�,J�ng instru ent was acknowledge efore me
this day of I c/' 20 by this�iYJday of t1011' 20�by
Name of per making statement Name of perso making statement
Personally Known 7 OR Produced Identification Personally Known X OR Produced Identification
Type of Identificatio Type of Identification
Produced Produced
(19� i ��' LLK'Uut-'Az�-
ignature of Notary Public-�&Expires
rta Bennett ( 1 nature of Notary Public-State of Florida)
ARY PUBLIC JKRy Roberta Bennett
Commission No. TE OF FLORIDA Commission No. W� ARY PUBLIC
m#FF952012 o STATE OF FLORIDA
1/20/2020 Comm#FF952012
Aires /2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17