HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dated �'�� � 0 C Permit Number:
RECEIVED
Building Permit Application JUL 3 0 2018
Planning and Development Services
Building and Code Regulation Division 5T. 4ucte County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PR OPOSED.IMPRO,VEMENT LOCATION.
Address: 3 V ey;(IG-. an
Legal Description 3✓�+ 3 S hCG W ;400 '� �¢ S� ��tl O�
Property Tax ID#: -12, 33q- 0 00(o - 000- 1 Lot No.
Site Plan Name: Block No.
Project Name: Shingle re-roof
Setbacks Front Back: Right Side: Left Side:
`DETAILED'DESCRIPTION PF-W0' RK
_ .
rzVs �-v Steck re .,Ise.;( Iy(apc( j"yVulf 30 16 t vv S"e_r
3X-3 dr;� tee ( mac( G1( bc�4s � �fl� '� iab SG�<3fPS
'CONSTRUCTION INFORMATION
rtiona wor to e e orme under tispermit—check all t=appy:
HVAC Gas Tank ❑Gas Piping OGenerator
Shutters Windows/Doors
11 Electric Plumbing OSprinklers F�Roof Roof pitch
Total Sq. Ft of Construction: 1800 _ SFt of First Floor:
Utilitie
Cost of Construction:$I� � "`4 s: Sewer Septic Building Height: �y 1
OWNER/LESSEE. n CONTRACTOR.
Name Name:WWI-Wsr 'i
Address: _��� e-V�'�� Company:American Quality lnspedonand Repair ServioeQuateslna
City: Ft Pierce State:Fl_ Address: 629 20 st
Zip Code: 3 97,/�� Fax: City: 01 ,4-yo r7 �- State:Fl-
Phone No.352-303-1085 Zip Code: 32805 Fax:
E-Mail:lynelder@gmail.com Phone No.407-779-0060
Fill in fee simple Title Holder on next page(if different E-Mail: agroof@gmaii.com
from the Owner listed above) State or County License: CCC058019
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: g, Not Applicable
Name: Name:
Address: Address:
City: RPierm State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name-
Address:629 2G-
ame:Address:6232Gn 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,
accessary 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
cornmencing work o/r/recording our Notice of Commencement.
5 fere of Owner/Lessee/G. ntractor as Agent for Owner Signature ofn Tactor/License Holder l
' STATE OF FLORIDA. STATEN®FLORIDA
�( COUNTY OF 0 �
I The forgoing instru ent was acknowledged efore me The on,
instrument was acknowledged before me
i this.2a day of 20l by this 'day of t..l V 20 by
Name of person m6kid g statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Id,ntification
Produced Produced'
(Signature of Noh Public-State of Florida) t-(`ig�ii Ature of Notary Public-Stag MORGAN COU/`
/�1�� Notary Public-State ( rida
Commission No. Commission No.1 1<GI ,(off , aljCommission FF 9 8 7
"kt_' "J CHERYL:AHOWE i �r� My Comm.Expires Nov 2 2019Notary Pubtic- e of Floridaov
REVIEWS Rso PLANS ! VEGETATION SEA TURTLE MANGROVE
CO + s REVIEW REVIEW REVIEW REVIEW
DATE i
RECEIVED '
DATE
COMPLETED
Rev.8/2/17