HomeMy WebLinkAboutBuilding Permit Application i
TALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Mato
Date: 12/4/2018 PermitNumber: �p
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMIT APPLICATION FOR: Roof
=PROPOSED,IMP RO.VEMENT LOCATION; N
x 1 ,
Address: 655 Ponytail Lane
Legal Description: Palm Grove S/D BLK E Lot 28 (0.12 AC)(OR 1388-2961)
,Property Tax ID#: 3410-503-0165-000-6 Lot No. 28
Site Plan Name: Block No.
Project Name: , Falzarano
Setbacks Front Back: Right Side: Left Side:
,DET�A'ILED DESFCRIPTION OFINORK "A_
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.Tear off existing shingle roof. Install new GAF Architectural shingle roof system.
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CONSTRUCTION INFORMATION
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Additionalwor to be nertormed under this permit—check a appy:
11HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers 11 Generator W Roof Roof pitch
;Total Sq. Ft of Construction: 1,754 S . Ft.of First Floor:
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Cost of Construction:$ 13,500.00 Utilities: _Sewer Septic Building Height:
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OVI/NER/LESSEE x CONTRACTORa
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Name Virginia C FalzaranoName: Y Tro Glowth
Address: 386 NW Shoreview Drive Company: Advanced Metal Roofing, Inc.
City: Port St. Lucie State: FL Address: 4640 SE Quail Trail
Zip Code: 34986 Fax: City: Stuart State: FL
Phone No. 772-332-3200 Zip Code: 34997 Fax:
E-Mail: sunginger812@belisouth.net Phone No. 772-678-6654
Fill in fee simple Title Holder on next page(if different E-Mail: lisa.advancedroofing@gmail.com
from the Owner listed above) State or County License: CCC1327906
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTk' CTI,ON rLl' dN LAW INiFORMATIO,N ; � � ,°e49;
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DESIGNER/ENGINEER: xx 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: XNot 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
Itructure. 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
n accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
he following building permit applications are exempt from undergoing a full concurrency review:room additions,
laccessory 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 r recording our Notice of Commencement.
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Signature of caner/Lessee/Contractor as Agent for Owner Signature of Co actor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Martin COUNTY OF Martin
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of December 20_ by this day of December 20_ by
Troy Glowth Troy Glowth
Name oerson making statement Name'o erson making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(S gnature ofN ary Public-Stature of Notary Public-State of Florida)
FRANK ALYN VI S
Commissic No. VyCOMMISSION#FF fission No, y%� S
v* ea#RANK ALYN 1 S
••, �,�� EXPIRES October 19 2019 MY COMMISSION# F 981
r4o� �s a+sa PwN ' EXPIRES October 1 19
MOlI39fl-0157 fbr16�N
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17