HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: oZ�' �� Permit Number: O v7 9
RECEIVED
tam
x Building Permit Application
APR 25 2018 �
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Per ting
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: 3126 Columbrina Cir; Port St Lucie, FL 34952
Legal Description: SAVANNA CLUB-PLAT TWO- BLK 14 LOT 4(OR 3863-703)
Property Tax ID#: 3425-702-0116-000-5 Lot No.4
Site Plan Name: Block No. 14
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Reroof- Remove existing roof covering, dry in with self adhering underlayment and install new asphalt
shingles.
MOBILE HOME
CONSTRUCTION INFORMATION:
Additional work to be performed under t ispermit—check a apply:HVAC Q Gas Tank ❑Gas Piping _Shutters 11 Windows/Doors
Electric ❑ Plumbing Sprinklers Generator Roof 3/12 Roof pitch
Total Sq. Ft of Construction: 1512 S . Ft. of First Floor:
Cost of Construction: $ 7925 Utilities: Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Ronald Lachance & Mary Apanowicz Name: Michael Miller
Address:49 Birch St Company: Trade Winds Roofing, Inc
City: Plymouth State:MA Address: P.O. Box 13208
Zip Code: 02360 Fax: City: Ft Pierce State:FL
Phone No.774-454-6856 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
commenci w or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA C STATE OF FLORIDA S�
COUNTY OF ��-'��- 111E \ COUNTY OF lsl� 1
The for oing instr ent was acknowledge before me The forgoing instrument wa acknowledged before me
this day of 20�by thisl5 day of 20\6 by
ch cl"—L� I )l � V N r V�r,1 0 � MA�� 2 'r
Name of person aking statement Name of person aking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
ProdiAced Produced
(Signature of Notary Public- F16da)Lyne Wilkin (Signature of Notary Publi4EI
NOTARY PUBLIC �ic1a Lyne Wilkin
Commission No. ST"Iff FLORIDA Commission No. OTWY PUBLIC
L s Comm#GGIO3860 I OF FLORIDA
I ® Expires 9/4/2021 Comm#GGIO38W
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17