HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l D
Date: d f ` Permit Numbe �' FPil
AUG 2 1 2015
Building Permit Application
Planning and Development Services Permitting Department
Building and Code Regulation Division S.L. Lucie \COu nty, FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATFON:
Address: 8234 Maidencane PL Port Saint Lucie FI 34952
Legal Description: LAKE LUCIE ESTATES PLAT NO. ONE LOT 123
Property Tax ID#:.3426-703-0137-000-4 Lot No.123
Site Plan Name: WILSON Block No.
Project Name: WILSON
Setbacks Front NIA Back: NIA Right Side: NIA Left Side: NIA
DETAILED DESCRIPTION OF WORK:
REMOVE ROOF SHINGLE
INSTALL PEEL & STICK UNDERLAYMENT
INSTALL NEW SHINGLE / OWEN CORNING / DURATION
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check ail appy:
HVAC Gas Tank OGas Piping _Shutters ❑,Windows/Doors
Electric l Plumbing OSprinklers Generator W1 Roof Roof pitch
Total Sq.Ft of Construction: 1424 Sq. Ft.of First Floor: 1424
Cost of Construction:$ 11,2000.00 Utilities: LJ Sewer 0Septic Building Height: 8
OWNER/LESSEE: CONTRACTOR:
Name ELIZABETH WILSON Name: MAURICIO.ORELLANA
Address:8234 MAIDENCANE PL Company: ONE CONSTRUCTION&ROOFING CONTRACTORS
City: PORT SAINT LUCIE State:FL Address: 2766 SW EDGARCE ST
Zip Code: 34952 Fax: City: PORT ST LUCIE State:FL
Phone No.772-349-1576 Zip Code: 34953 Fax:
E-Mail:NIA Phone No. 7720-240-9497
Fill in fee simple Title Holder on next page(if different E-Mail: oneconstructionservices@yahoo.com
from the Owner listed above) State or County License: CCC-1330623
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
PPLEMENTAL CONSTRUCTION LIE ,LAW IN.
SU
DESIGNER/ENGINEER: _Not plicable MORTGAGE COMPANY: _Not Applicable
N a m e:ELIZABETH WILSON N am e:MAURICIO ORELLANA
Address:8234 Maidencane PL Port Saint Lucie 34952 Address: 8234 MAIDENCANE PL
City. PORT SAINT LUCIE State: City: PORT ST LUCIE State:
Phone Zip: Phon .
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING CO NY: Not Applicable
Name: Name:
Address:2766Sw, GARCEST Address:
City: /1 City:
Zip: Phone: Zi Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1°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 appl'icabie 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
bofo-re thefirst'inspection. ff you intend to 6btain financing, tbhn ilt with kiender or-an attorney'before
commencing work or recording our Notice of Commencement.
d.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF 6T• Lu—c t C
The forte instr ment was acknowledged efore me The forgWo instrument was acknowledged before me
til bkO1 day of V.C� 204 by this AO day of 20AS by
Name of person making statement Name of person making statement
Personally Known_AOR Produced Identification Personally Known t---76R Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signa ur o Notary Public-State p �E�gri a Sig',ature of ary Publ `P,11„I°Flo R
� � P , , _ ot�r Public State of Florid
Ol,t Ys�,, AULETTE BLAIR-ALEXA DER
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Com is ion No. _, �; � 9ary Public-State of F o ' fission No. —I-1 FF`�p� My�Expires Sep 6,202
Commission#FF 995699
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My Comm.Expires Sep 6,2020
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Rev.8/2/17