HomeMy WebLinkAboutBuilding Permit Application R 1
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ALLAPPLICABLE INFO MUST BE_COMPLETED FOR APPLICATION TO BE ACCEPTED ;
;Date: Permit Number:
I$D3-OI'75
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Building Permit Application
Planning and Development Services
iBuilding and Code Regulation Division x'/
12300 Virginia Avenue,Fort Pierce FL 34982 '
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
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PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT'61
LQ,CAT,ION I"� t .3 >_
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Address: 3820 Spatterdock Ln, Port St Lucie; FL 34952 •,
Legal Description: THE PRESERVE AT SAVANNA CLUB-ELK 46 LOT 6(OR 3112978)
Property Tax ID#: 3425-706-0064-000-7 Lot No.
Site Plan Name: j Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:' KA
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DETAILED DESCRIPTION"OF WORK �M
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Reroof- Remove existing roof covering, dry in with self adhering underlayMlent and install new asphalt
shingles.
MOBILE HOME I.!
CQNSTRUCTINtIN'FORNIATION
itiona work to be pertormed under this permit—check a � apply:
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HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
0 Electric ElPlumbingOSprinklers E Generator D Roof 3 12 Roof pitch
Total Sq. Ft of Construction: 1247 S . Ft.of First Floor::
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Cost of Construction:$ 5785 Utilities: Sewer El Septic Building Height:
OWNERILESS,,EE CONTRACTOR 'S
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'Name Thomas&Hanna Nowacki Name: Michael Miller
;Address:3820 Spatterdock Ln Company: Trade Winds Roofing, Inc
Port St Lucie FL P.O. Box'13208 `
,City: State:_ Address: I '
+ Zip Code: 34952 Fax: City: Fort Pierce State:FL
;Phone No.772-418-3306 Zip Code: 34979 Fax: 772-466-9725
E-Mail: Phone No. 772-466-9420 j I
Fill in fee simple Title Holder on next page(if different E-Mail: mike@tradewindsroofing.com
from the Owner listed above) State or County License: CC CO57399
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. j
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SUPPLEMENTAL CONSTRUCTIONLI`EN tiLAW,INF' i RIVIAIIlI
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: i Not Applicable
Name: Name: i
Ad d ress: Address:
City: State: City: State:
Zip: Phone Zip: Phone: I'
!FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
!Name: Name: I' !
{Address: Address: I, i
i City: City:
Zip: Phone: Zip: Phone: i I
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 Aiiiendmehts.
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 resulfln 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 k orAcording your Notice of Commencement. j
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Signature of Own&/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
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STATE OF FLORIDA I STATE OF FLORID,
COUNTY OF �; COUNTY OF
The for oing instr }ent wa cknowledge before me The ffoorgping instr le t w s) cknowledg d efore me
this' day of I ► I�/�l�(j� 20� by this 1T "day of 20Nby
)CIA t � U
f\[� Ly" �1` V
Name of persoaking statement Name of per caking statement
Personally Known . OR Produced Identification Personally Known Ok;Prodyced Identification
I Type of Identification Type of Identification
Produced
3uced
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(Signature of Notary Public-Si/to of Florida) (§rg'nafWFe of NotaryPubli State of Florjd4t
Felicia L ne Witkin tAR e i i'a Lyne Wilkin
Commission No. t y I � NQ, '�PUBLIC
NOT�i PUBLIC Commission No. 77`` Q
cg STATE OF FLORIDA ei F FLORIDA
' Comm#GG103860 0 ,� Comm#GG103866
':Q:l 94412021
NOR Expires 9 !
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED I'
Rev.8/2/17
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