HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: • �• I Permit Number: / 70_7�—
Building Permit Application MAR =5 2018
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 El
PROPOSED IMPROVEMENT LOCATION:
Address: 8276 SANDPINE CIRCLE PORT SAINT LUCIE FL 34982
Legal Description: LAKE LUCIE ESTATES PLAT NO.ONE LOT 29(OR 1228-2536;1333-2861)
Property Tax ID#: 3426-703-0043-000-8 Lot No.29
Site Plan Name: N/A Block No. N/A
Project Name: N/A
Setbacks Front N/A Back: N/A Right Side: N/A Left Side: N/A
DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING ROOF SHINGLE/ RENAIL PLYWOOD TO CODE
INSTALL TRI-BUILT/ PEEL & STICK UNDELAYMENT
INSTALL OWEN CORNING SHINGLE
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit–check all appy:
HVAC Gas Tank Gas Piping _Shutters a Windows/Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator 2 Roof �'{ / Roof pitch
Total Sq. Ft of Construction: 2839 S . FtFt.of First Floor: 2P:3q 0
Cost of Construction:$ 17,000 Utilities: L I Sewer[]Septic Building Height: 8'
OWNER/LESSEE: CONTRACTOR:
Name BETTY A SCARSELLA Name: MAURICIO ORELLANA
Address:8276 SANDPINE CIRCLE Company: ONE CONSTRUCTION&ROOFING CONTRACTOR
City: PORT SAINT LUCIE State: FL Address: 2766 SW EDGARCE ST
Zip Code: 34982 Fax: N/A City: PORT SAINT LUCIE State: FL
Phone No.772-897-6677 Zip Code: 34953 Fax:
E-Mail:N/A Phone No. 772-240-9497
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
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:BETTYASCARSELLA Name:MAURICI0ORELLANA
Address:8276 SANDPINE CIRCLE PORT SAINT LUCIE FL 34982 Address: 8276 SANDPINE CIRCLE
City: PORTSAINTLUCIE State: City: PORTSAINTLUCIE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2766 SW EDCARCE ST 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.
C �
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF-- COUNTY OF-W.IE
The for ng instr ment was acknowledged efore me The for�ping instrument was acknowledged efore me
this ay of e 20�by thits�3�day of� �\� 20 Uby
Name of person making statement Name of person making statement
Personally Known L-'bR Produced Identification Personally Known AL— OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature o otary Public- orl a `Sig ture of Notary Public-State of Florida)
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"!A,%"ra`°�e'a PAULETTE BLAIR ALEXA D R
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Commission No. =�20 ;° Sflet�ry Public State of Ii�� is No� �S (Seal)
Commission I FF 995 99
osv�o?�`' My Comm.Expires Sep 6 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