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HomeMy WebLinkAboutBuilding Permit Application I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: Permit Number: I oz ° ©5su URECEIVED Building Permit Application Q►/r, Q 201 Planning and Development Services """ittin 8 Regulation Division - Building d nue,Fort Pierce FL 34982 St' CuC,e punt e 2300Virginia ' Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential x :PERMIT APPLICATION FOR: Roof L' 'PROPOSED IMPROVEMENT LOCATION: Address: 5115 Myrtle Drive Legal Description: Indian River Estates Unit 07-BLK 48 Lots 30 and 31 (Map 34/02S) (OR 1613-60,62;1673-2551;1704 -1134;1976-112) 3402-608-0286-000-7 7 Property Tax ID#: Lot No. Site Plan Name: Block No. 48 (Project Name: Southerly Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Remove existing shingle roof replace w/ new shingles i CONSTRUCTION INFORMATION: Additional work to be nprtormed under t ispermit—check all that appy: HVAC Gas Tank F_]Gas Piping _Shutters Q Windows/Doors Electric ❑ Plumbing OSprinklers Generator R1 Roof (� Z' Roof pitch Total Sq. Ft of Construction: 4401 S . Ft.of First Floor: 4401 ,Cost of Construction:$ 20,898.00 Utilities:Sewer Septic Building Height: :OWNER/LESSEE: CONTRACTOR: ;Name Laney&Sandra Southerly Name: Danielle Beggs Address:5115 Myrtle Drive Company: Alliance Group 'City: Fort Pierce State:_ Address: 532 NW Mercantile PL#113 Zip Code: 34982 Fax: City: Port St. Lucie State:FI i Phone No. Zip Code: 34986 Fax: 772-492-8008 E-Mail: Phone No. 772-492-8006 'Fill in fee simple Title Holder on next page(if different E-Mail: wanda@alliancegroupllc.com from the Owner listed above) State or County License: CCC1330918 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.- DESIGN ER/ENGI NEER: NFORMATION: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 iWARNING 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 Ow Lessee/Contractor as Agent for Owner Signature of t ctor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OFSt Lucie COUNTY OFstl_ude The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 28th day of June 20— by this 28th day of June 20_ by Danielle Beggs Danielle Beggs Name of person making statement Name of person making statement Personally Known x OR Produced Identification Personally Known x OR Produced Identification Type of Identification Type of Identification Produced Produced n � Rua,(x—, (Signature o (Signa rli1 ' Notary Public State of Florida yr Notary public State of Florida Commission N '� 4; Karolyn H Le B g@aI Comm ii & Karol n H LeBlanc (S 1) < y ommission G 224008 ' < My Commission G 224008 ►I Expires 06/0312022a w Expires 0810312022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17