HomeMy WebLinkAboutROOF - FIBERGLASS SHINGLE All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 10 Permit Number: \qJG-_ 03 S�
RECEIVED
Building Permit ApplicatiorbCT F6 2018
Planning and Development Services
Building-and Code Regulation Division - ST. Lucie County, P,rmitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:
Address: 57,12n t 0 -1-1 -D&f-I—OCA,s
Legal Description: PL.4rf__ / RL IL Z �< 2 2
Property Tax ID#: 34 7s- —?0 ) 60;?92 Do6RLot No. 27
Site Plan Name: Block No. 2
Project Name:
Setbacks Front Back: Right Side: Left.Side:
t'Z FC-i
T� t « r- v�v�t.v�t�r ���L -er 5 c I c.�L LAQ
ttiona workto a performed under this permit-check a that app y:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: 1 Sq. Ft.of First Floor:
IF
Cost of Construction:$ 61 UUUtilities: _Sewer _Septic Building Height:
Name OAAr"L— -C-0 c r-15,-, er i i I Name:
Address: 8'Zp I) Company: t
City: State: (, Address: ?,71 �54�rc3�rt�.�bv�
Zip Code: 3Yq rZ Fax: City:Vii' State�L
PhoneNo. � D �� ���� Zip Code: 34cZ SP-2, Fax:
E-Mail: Phone No 'Yw 71A k6'('�Z
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
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 thepermit 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 ou intend to obtain financing; consult with lender or orney before
commencingwork ord' our Notice of Commencement.
Sig ature o O es Contract. ent for Owner Signature of ontra r rcense Holder
STATE OF FLOR - STATE OF FLORID
COUNTY OF COUNTYOF
The forgoing'instrument was acknowledge before me The forgoing instrument was acknowledge before me
this�day of Q c.� .20A by this k4 day of d cb .20LI by
S�be��,r �.d►.s�•or o q '���J e.v�. C a,s��v► u
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pu Ic-State of Florida) (Signature of Notary)5ublic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identcation
Produced ADS L. p=s-`` ProducedIRAPIEGNFNs
A�{E G\v[{15 ;g aY PU3r, GOMtd1SS10N#GG U220' t;
Commission No. b (S {S G 22,? �§ 0 t
c �� �N# Go o Commission No Ce 202U
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4p PUa�., Dhl' Bcembet ld-t` ed'rhNldowN u
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REVIEWS FRONT SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW . REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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