HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Il
Date: Permit Number: ' p V�� -ray a 3
•
RECEIVED
Building Permit Application MAR 15 701E
Planning and Development Services Permitting Department
Building and Code Regulation Division St. Lucie Cou tv
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 192 SE Selva Ct, Port St Lucie, FL 34983
Legal Description: RIVER PARK-UNIT 7-BLK 62 LOT 5 (MAP34/28S)(OR 1280-142)
Property Tax ID#: 3419-550-0001-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Reroof- Remove existing roof covering, dry in and install new asphalt shingles.
CONSTRUCTION INFORMATION:
Additional work to be ertormed under t is1_1permit—check affpplyHVAC Gas Tank ❑Gas Piping _ hutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 2658 Sq. Ft. of First Floor:
Cost of Construction: $ 11,285 Utilities: 0 Sewer F]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Philip& Deborah Pizzimenti Name: Michael Miller
Address:2606 Gray Twig Ln Company: Trade Winds Roofing, Inc
City: Fort Pierce State:FL Address: P.O. Box 13208
Zip Code: 34951 Fax: City: Fort Pierce State:FL
Phone No.772-971-8372 Zip Code: 34979 Fax: 772-466-9725
E-Mail: Phone No. 772-466-9420
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 C057399
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,,pr rerQrding vour Notice of Commencement.
Signatu4 of Owner/Lessee/Contractor as or Owner Signature of Contractor/license Holder
STATE OF FLORID A STATE OF FLORID
COUNTY OF �`� �� COUNTY OF l
The forgoing instrument was acknowledge efore me The forgoing instrument was a knowledged before me
this�day of Flo-fG�'� 20 IUby this L':y day of y'YVct v G 20 LB by
Name of peron ing statement Name of per on ing statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-S e ridill`kcia Lyne Wilkin (Signature of Notary Public- to oftoric d
�;� y e icia Lyne Wilkin
NOTARY PUBLIC g Y PUBLIC
Commission No. WTE OF FLORIDA Commission No. �X OF FLORIDA
` Comm#GG103860 `� Comm#GG103860
E1 10 Expires 9/4/2021Pvpir�Q 9/4A2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17