HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: on�q
RECEIVED
Building Permit Application IUN 0 5 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 0
PROPOSED IMPROVEMENT LOCATION:
Address: 3485 ROSELAWN BLVD, FORT PIERCE, FL 34982
Legal Description: SUNRISE HOMESITES S/D BLK 2 LOT 8(0.24 AC)(OR 3719-1372)
Property Tax ID#: 2428-702-0032-000/8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
ROOFING REPLACEMENT k
Se I Pa�nearelD v+nger�A`(IH.ell�
6
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—c ec a appy:
HVAC 11 Gas Tank ❑Gas Piping _Shutters Windows/Doors
11 Electric 0 Plumbing F]Sprinklers Generator 2Roof Roof pitch
Total Sq. Ft of Construction: 2001 Sq. Ft.of First Floor:
Cost of Construction:$ 10,000.00 Utilities:Sewer E]Septic Building Height: 96"
OWNER/LESSEE: CONTRACTOR:
Name DINO ORTEGA Name: N/A
Address: 3485 ROSELAWN BLVD Company: GIRE ROOFING SOUTH
City: FORT PIERCE State:FL Address: 535 16TH STREET
Zip Code: 34982 Fax: City: WEST PALM BEACH State:FL
Phone No.(772)444-5935 Zip Code: 33407 Fax: 561-423-2879
E-Mail:nenelindo48@aol.com Phone No. 800-295-1253 217-202-4500
Fill in fee simple Title Holder on next page(if different E-Mail: gireroofing@yahoo.com
from the Owner listed above) State or County License: CCC 1327696
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:N/A
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: xNot Applicable
Name:NSA Name:NrA
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 recordingyour Notice of Commencement.
Signature o ner/Lessee/Contractor as Agent for Owner Signat f Contractor/Lice se Holder
STATE FLORIDA ST E OF FLORIDA
COU OF 11(',1 LINTY OF
The orgoing instrument was acknowledged before me The forgoing instr 'nent was acknowledge before me
this�day of 20a by this�day of 20� by
►�►,)►t�! �:�t�(L' _ ice.
Name of person making statement / Name of person making statement ✓
Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification
Type of Identification Type of Identification 11
Produced Produced 7r-1_
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(Sign ture of N (Signature ofNotary P lic-State of Florida)
`,,PPYp�B, KA=':� State oPublic pYP,, �Commission No. __ - 484 Commission No. �" �e,; KAR,, LSEN
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Y Co GG 20748
June 1 20 xPlres
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIE
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17