HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: J �� Permit Number: I I
J _
• RECEIVED
Building Permit Application MAY o 9 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
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: 213 N 40th st Fort Pierce FI 34947
Legal Description: wilbuwe blk 5 s 45 ft of lot 12 and n 30 ft of lot 13
Property Tax ID#: 2408-603-0052-000-8 Lot No.12-13
Site Plan Name: Linda Block No. s
Project Name: Linda
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove exiting roof shingle
Install Peel & stick underlayment
[CONSTRUCTION INFORMATION:
Additional work toe performed under this permit—check all apply:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric F]Piumbing O Sprinkiers Generator Roof 5/71z Roof pitch
Total Sq. Ft of Construction: 1180 Sq. Ft. of First Floor: 1180
Cost of Construction: $ 9500 Utilities: 0 Sewer I—VIISeptic Building Height: 8
OWNER/LESSEE: CONTRACTOR:
Name Linda Thompkins Name: Mauricio Orellana
Address: 213 N 40th st Company: One Construction&Roofing contractors
City: Fort Pierce State: Fl Address: 2766 sw Edgarce st
Zip Code: 34947 Fax: City: Port Saint Lucie State: fl
Phone No.772-678-0098 Zip Code: 34953 Fax:
E-Mail:N/A Phone No. 772-519-2449
Fill in fee simple Title Holder on next page( if different E-Mail: oneconstructionservices@yahoo.com
from the Owner listed above) State or County License: CCC-1330623
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
N a m e:Linda Thompkins N am e:Mauricio orellana
Ad d ress:213 N 40th st Fort ce F134947 Address: 213N4
City: Fort Pierce State: City: Portsain cie State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HO _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:2766. garcast 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.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLOR11DA
COUNTY OF � COUNTY OF S=a
The for oing instru nt was acknowledged before me The for ing instrylrrT��ent was acknowledge efore me
this�day of 20�by this L�day of �V\ u 20 ( by
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Name of person m ng statement Name of pers9n making statement
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Type of Iden ' ication
Produced Produced 1 l�
�x� fi/ �W �A UAA-11)
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(Signature of Nota ublic-St of Florida) (Signature of Notary Public-Stz te of Flgrida )
�� UZ eai : SSION M
Commission No. ��� Q n No. � �'
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-� � CONNIE M VER ",?a,,v EXPI ES Decemhe, 17,
4 Notary PUNIC•Ste a of Florida 14o713S3o'`.i3 Flondallotary erviceco,
r Commission
F`w�•' Y Comm.ExpiresJul 29,2020
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DATE
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Rev. 8/2/17