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HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL 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: 10380 SW Village Center Dr. #232 Address: City: City: Zip: Phone: Zip: Phone: UvvivM/ I -VIM I KAL! UK 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 Horne 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. Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF— 411- - Signa ure ofContractor/License Holder STATE OF FLORIDA COUNTY OF --- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this / day of }'1'%r 20 j by this I day of I IQ J _ 20 /,? by Name of person making statement Personally Known x OR Produced Identification Type of Identification Produced of Notary Public - Commission No. FF112219 REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17 LETTE BENICHIO IMISS ION 9 FF 112219 RLS: July 18, 2018 Name of person making statement Personally Known x OR Produced Identification Type of Identification Produced (Sign ure of Notary Public- State of Florida j mission No. FF112219� ETTE BENICHIO .!"i .a31 C0 h71SS10N 0 FF 112219 n� EXPIRES. July 18, 2018 UPERVIS S REVIIEWOR REE NS W VREV EW ON S REVIEW I M EVIEWVE ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 05/01/2018 z6UNTY F L O Permit Number: Building Permit Application Planning and Development Services 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 PROPOSED IMPROVEMENT LOCATION: Address: 7920 Black Tern Dr. Port St Lucie, FL 34952 Legal Description: Eagles Retreat at Savannah Club ( PB 42-24) Blk 54 Lot 15 Property Tax ID #: 3424-701-0031-000-9 Lot No. 15 Site Plan Name: Block No. 54 Project Name: Dom Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Remove existing roofing, renail deck, install underlayment and new asphalt shingles. CONSTRUCTION INFORMATION: itlona wor toe e orme un er t is permit — c ec a app y: OHVAC Gas Tank Gas Piping _rl Shutters n Windows/Doors I�i / oors Electric 0 Plumbing 05prinklers Generator Roof 312 Roof pitch Total Sq. Ft of Construction: 3513 sq ft Cost of Construction: $ 9360.00 OWNERAFSSEE: NameJarres F Dorn Address:7920 Black Tem Dr. SFt. of First Floor: _ Utilities:]Sewer ❑Septic City: port St Lucie State:FL Zip Code: 34952 Fax: Phone No. 772-905-8501 E -Mail: carold38@comcast.net Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Building Height: CONTRACTOR: Name: Larry Mcdonald Company: southeast General Contractors Group Address: 10380 SW Village Center Dr. #232 City: Port St Lucie State: FL Zip Code: 34987 Fax: 877-756-0007 Phone No. 877-4.07-3535 E -Mail: LMCDONALD@SOUTHEASTCONTRACTING.COM State or County License: cccl330002 If value of construction is $250[3 or more, a RECORDED Notice of Commencement is required.