HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 07-24-2018 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 Residentia
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: "32 35 40 N 220 FT OF S 266 FT
Property Tax ID #: orA a, J t,' I Lot No.
Site Plan Name: irs L� - /�40e&JIF- Block No.
Project Name: Shingle re -roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION: V
Additional work toe nerformed under this permit- check all appy:
HVAC Gas Tank ❑Gas Piping _ Shutters Windows/Doors
11 Electric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 1800pp S . Ft. of First Floor: _
Cost of Construction: $ � -l. Utilities. Sewer Septic
Building Height: fLI 1
OWNER/LESSEE:
CONTRACTOR:
Namell'V14/US
(l�
Name:VViL�i'I� Ds%�(
!X'
Address: v eV/ 'VF, 5 7—
Company: American Quality Inspection and Repair Service Quotes Inc.
Address: 629 20 st
City.. Ft Pierce State:Fl_
Zip Code: S q/� a�9 ( Fax.
�"
City: ® adv E—�- State: Fl.
Phone No. 352-303-1085
Zip Code: 32805 Fax:
E-Mail:lynelder@gmail.com
Phone No. 407-779-0060
E -Mail: agroof@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
State or County License: CCCO58019
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
NEER: x Not
Name:
Address:
City: a vier
Zip: Phone
State
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address: 629 a; st
City:
Zip:
Phone:
MORTGAGE COMPANY: _v,_ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
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 pians, 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-residentiai 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
�L ..4-- _n Aintiro of rr%mmanramont
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S re of Owner/ Lessee/G ntractor as Agent for Owner
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S gnature of n ctor/license Holder
STATE OF FLORID
STATE OF FLORIDA 1
COUNTY OF A :�
COUNTYOF � �
The forgoing instruKnent was acknowled ed efore me
, The forgoing instrument was acknowledged before me
tfiis 'day of 1 20A by
this P.A day of �, 20 by
I , v
Name of person m ki g statement
Personally Known 1----O Produced Identification
Name of person making statement
Pers" is..) OR Produced Identification �_ I
Type of Identification
Typ4 of Identification
L
Produced
Produced'
! {Signature of No Public- State of Florida
�$igr&ture of Notary Pu lic- State qo ,J MORGAN COU
Notary Public - State
Gt
Commission No.
Commission No. alkommission # FF 91
CHERYL A HOWE
�'%;r� My Camm. Expires NovNotary
Public - State of Florida
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PLANS
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SEA TURTLE
MANGROVE
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REVIEW
REVIEW
REVIEW
REVIEW
I DATE
RECEIVED
DATE
I COMPLETED
Rev. 8/2/17
2019