HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECEIVED
Building Permit Application JUN 2 5 201811
Planning and Development Services g ST. Lucie County, Permittin
Building and Code Regulation Division main
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: 3o9D beolt fort.-4 �r �Cr� �L 3L[9$
Legal Description: 30 35 40 FROM SW COR OF SE 1/4 OF NW 1/4 OF NE 1/4 RUN W 8.27 FT,TH N 836.15 FT FOR
POB,TH RUNE 68.36 FT,TH S 98.89 FT, TH W 68.36 FT,TH N 98.89 FT TO POB (20)(0.16 AC) (OR 2165-2600)
Property Tax ID#: 2430-121-0003-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front 15.5 Back: 14.3 Right Side: 26.1 Left Side: o�to
DETAILED DESCRIPTION.OF WORK:
- N lA k A;2 'd ckc u n RS
Re-roof.M i�4(L oC'S= �xis�-'�n$ Sh;��l&�Q�a� - RSP / P _ ., .
11��d�d . �rasa111�� 6L��L� Ltr�d�tl, m� '(�s�R coy-41n A5 k�15hingt�
r
CONSTRUCTION.INFORMATION: ,
Additional wort
o be nerformed under t ispermit—check all appy:
HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric Plumbing []Sprinklers FIGenerator Fv-1 Roof ��-�2 Roof pitch
Total Sq. Ft of Construction: ( 10100 S . Ft.of First Floor: 1 I
r�11 i
Cost of Construction:$ �9. J Utilities. _Sewer g Septic Building Height: o�
OWNERAESSEE:'= CONTRACTOR: n
NameS}f,OhEn {^�(�(Z(u5 n Name:
Address: 3090 kDrnE (2d Company:
City: i ' Pi X20-,_ State:FL Address:
Zip Code: 34981 Fax: City: State:
Phone No.772-579-3561 Zip Code: Fax:
E-Mail:stevegetdown@gmail.com Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN_LAW;IN FORMATION:.. :_
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name: (2g Edam o(t-(e�, � � -F►"by1
Address: Addret Hh 6� W#9ml�3
City: State: City: ra LW State: Tx
Zip: Phone Zip: 76261-9063 Phone:855-690-5900
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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., ou intend to obtain financing, consult with lender or an attorney before
commencingwork or reco}��In our Notice of Commencement.
Signature of Owner/L 5sep%Contractor as Agent for Owner Signature of Contractor/License Holder
V
STATE OF FLORIDA , STATE OF FLORIDA
COUNTY OF __ ` . LUC'�I F_ COUNTY OF
The forgoing instr ment was acknowledge before me The forgoing instrument was acknowledged before me
this '2S day of 20 10 by this day of 20_ by
me of person making statement Name of person making statement
Personally Known OR Produced Identification V/ Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
}
(Signature of Notary Publi 6. ignature of Notary Public-State of Florida)
;may p��� KAREN S. NIELSEN
Commission No. _:� 4�:sta(6egl lorida-Notary Publ mmission No. (Seal)
Commission # GG 20748
+ c My Commission Expires
June 12, 2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17