HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLINF jMUUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: /� GU Permit Number: 0 cM-Olo3
f,, ---_..;a}`_, y.— RECEIVED
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Ca o NTYo xt
MAR 2 3 2018
mmilBuilding Permit Applicati • n
ST. Lucie County,Per
Planning and Development Services t1?►1;G�f1
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: To Select from dropbox, click arrow at the end of linet 0Oc S\N4Q,,,
PROPOSED IMPROVEMENT LOCATION:
Address: 16 Lagos Del Norte, Fort Pierce, FL, 34951 (Spanish Lakes)
Legal Description:
Property Tax ID#: \'.0V- \1V- stt,0 )— 0 O G —S Lot No.
Site Plan Name: Block No.
Project Name: P153 JACK PERNA
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Tear off shingles, felt, fiberglass singles, nails, flashings, air vents, drip edge
CONSTRUCTION INFORMATION:
Additional work to be pertormed under this permit—check all apply:
LIHVAC _Gas Tank []Gas Piping _Shutters Q Windows/Doors
ElElectric ❑ Plumbing Sprinklers Generator l Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 1700 S5. Ft. of First Floor: j�
Cost of Construction:$ 7,294 Utilities: 1 Sewer Septic Building Height: I .� i
'OWNER/LESSEE: CONTRACTOR: '
Name Jack and Susan Pema Name: Chris Dutruch
Address: 16 Lagos Del Norte Company: My Affordable Roof(MAC MAR, LLC)
City: Fort Pierce State:FL Address: 1585 Kennesaw Dr.
Zip Code: 34951 Fax: —• City: Clermont State:FL
Phone No.772-468-4813. 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: CCC1331305
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 your Notice of Commencement.
4:::: :2.....-------
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/Licens o der
STATE OF FLORIDA j e STATE OF FLORIDAf
COUNTY OF V) :US/ cC. COUNTY OF VO G (IS/ C(
The frt I for oing instru ent was acknowledged before me The for oing instrumept was acknowledgedbefore me
this t 5-day of /V I 1 ,20/g1 by this / day of "LOT-t ,20 , by
Name of perr,spn making statement Name of pers n making statement
Personally Known A, OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
fjj-..\ 1 • 1
\ I1/4.k_d i IIPA —)Th'
(Signature of Notary Public gg�ate o� rl�a�ennett (Signature of Notary Public-gg to of r' a)
o '1'r ott+R FF{b�� a Bennett
,�`' 1.0 NOTA Y PUBLIC a� ;; NOTA P LIC
EORIDA
Commission No. —'t _STATt8Ir LORIDA Commission No. o _STAT
+�.�a Comm#FF952012 ��";;�2 Comm#FF952012
ATE 1S Expires 1/20/2020 / E1'lb Expir s 10n/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