HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
Planning and Development Services MAR e 9 2U18
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
a
PROPOSED IMPROVEMENT LOCATION:
Address: 6505 CITRUS PARK BLVD, FT.PIERCE, FL 34951
Legal Description:
Property Tax ID#: 1301-611-0399-000-6 Lot No.16
Site Plan Name: Block No. 118
Project Name: EAMELLO
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE AND UNDERLAYMENT; APPLY NEW UNDERLAYMENT AND NEW SHINGLES
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—c ec a appy:
HVAC Ei Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator R1 Roof 3.5/12 Roof pitch
Total Sq. Ft of Construction: 2826 Sq. Ft.of First Floor:
Cost of Construction:$ 18089 Utilities: Sewer E:l Septic Building Height:T
OWNER/LESSEE: CONTRACTOR:
NameALLISON EAMELLOName: SERGIO ZELIGMAN,
Address:6505 CITRUS PARK BLVD, Company: PANDA CONTRACTORS
City: FT.PIERCE State:FL Address: 4560 U.S 1
Zip Code: 34951 Fax: City: VERO BEACH State:FL
Phone No. 05• O I Zip Code: 32967 Fax: 866-711-0251
E-Mail: Phone No. 772-778-6803
Fill in fee simple Title Holder on next page(if different E-Mail: CE04CRRS@GMAIL.COM
from the Owner listed above) State or County License: 006984
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. g;7 73
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:ALLISON EAMELLO Name:SERGIO ZELIGMAN
Address:6505 CITRUS PARK BLVD,FT.PIERCE,FL 34951 Address: 6505 CITRUS PARK BLVD
City: FT.PIERCE State: City: VERO BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:4560 U.S 1 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.
Sign at ner/Lessee/Contra as Agent for Owner Signature of Cont4c_tor/LicenseoKolder
STATE OFTLORIDA STATE OF FLORIDA
COUNTY O.F '+—+�c���y+� �t-v�'� COUNTYOF
The forgoing instrument was acknowledged before me The forgoing instrument w,as acknowledged before me
this�day of K c C� 20& by this day of �� .20119 by
a rt-� '5--9 to --&_I L�14,C ki
me of person nialking statement Nam6 of person making statement
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Ry Andres Baena
(Sig ture No ary Public- III RY PUBLIC (Signature f Not Public-St d�I�TARY PUBLIC
o STATE OF FLORIDA
Commission No. O =g6m9W GG078567 Commission No. 61OW5�w "�� 078567
?STATE OF ST GGFLORIDALORI
CE 191 Expires 3/2/2021 Expires 3/2/2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17