HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \ `� Permit Number:AWA
RECEIVED
Building Permit Applicati n
Planning and Development Services AUG 3 Z01�
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 5688 bora chica ct.ft pierce fl 34982
Legal Description: tropical isles unit c-21
Property Tax ID#: 3410-508-0060-000/5 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK':
reroof shingles to shingles/emove existing roof,30#felt underlayment
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all appy:
HVAC Gas Tank ❑Gas Piping MGenerator
Shutters Windows/Doors
E]Electric Plumbing USprinklers Z Roof 3 Roof pitch
Total Sq. Ft of Construction: /�()('� Sr S .Ft.of First Floor:
Cost of Construction:$ 5600.00 Utilities:]Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Nametropical isles co-op Name: roland wiley
Address:5688 boca chica ct. Company: shoreline roofing
City: port st lucie State:fl Address: 1973 sw Glendale st
Zip Code: 34983 Fax: City: port st lucie State:fl
Phone No. Zip Code: 34987 Fax:
E-Mail: Phone No. 772-260-9565
Fill in fee simple Title Holder on next page(if different E-Mail: shorelineroofing@yahoo.com
from the Owner listed above) State or County License: CM 331170
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMER, INEW ISN LAW #NFQRMAT#DN:
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _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 you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Cont ct r as Agent for Owner Signature of Contractor/License Holde
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S_� ,X, COUNTY OF
The forgoing instrument was acknowledgel before me The forgoing instrument was acknowledged before me
this \S day of 4 J! 20 V% by this \S day of q J,!!N 20A by
(Name of person acknowled ing) (Name of person acknowledge g)
(Signature of Notary Pub c-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced �'l, L Produced 1. L EGNENS
Ns p o2s
Mpg\EG��o22p23 P�,..., OOMMISSION#G j6,20 ZO
Commission No. $5Ck"\Ce N# 020 Commission No. �ec�
OM 1SS\O tn�j'B�Zenid�wr� _ <_ EXPIRES otaryYU �UndeTwd
��y.;�:�:t;;r•,, N+`{G E$.Oe� ob11Cu� �N?r oFv;cec $ondedThNN
REVIEWS FRONT �'=:�,A.�Y`• 9 de SUPERVISOR PLANS VEGETATION ' SEATURTLE MANGROVE
COUNTE EW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/4014