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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO)MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_OAa,d `d Permit Number: RECEIVED ' - DEC 20 2018 Building Permit Application Planning and Development Services ST. Lucie County, Perrnitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Roof r I ks -PROPOSED IMPROVEMENT-LOCAT10N:----- Address: 14394 AMAPOLA CIRCLE FORT PIERCE FLORIDA 34951 1 Legal Description: Property Tax ID#: 3®to ' I l Q r 7 o � • ©cc)•(0 Lot No.13 AND 14 Site Plan Name: Block No. A Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTI ON,OF.WORK: btu-�l�S c 6-Z b, I-, JtA.N M C)VJ CONSTRUCTION INFORM?ATI'ON Additional work to be performed under this permit—c ec a appy: HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors Electric ElPlumbing Sprinklers Generator R1 Roof 1 Z Roof pitch Total Sq. Ft of Construction: 114 S�Ftj of First Floor: Cost of Construction:$ 5 Z(pp Utilities: L_ISewer Septic Building Height: OWN,ERAESSEE_: ,, CONTRACTOR.: Name GILBERT LA CROIX Name: EDWARD LECHNER Address:14394 AMAPOLA CIRCLE Company: EDIFICIUM CONSTRUCTION City: FORT PIERCE State:FL Address: 1215 CASTAWAY BLVD Zip Code: 34951 Fax: City: VERO BEACH State:FL Phone No. Zip Code: 32963 Fax: E-Mail: Phone No. 772 643 4513 Fill in fee simple Title Holder on next page(if different E-Mail: EDIFICIUMROOFING@GMAIL.COM from the Owner listed above) State or County License: CCC1331308 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SIJPPCEIVIENTAL:CONSTRUCTION LIEN LAWIN`FORMATIO'N 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:1215 CASTAWAY BLVD 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. Lliz—z— Signature of Owner/L ntractor as Agent for Owner Signature of Contracto cense Holder STATE OF FLORIDA STATE OF FLOIPIgA COUNTY OF 19+, 1---'s t 'Z COUNTY OF The forgoing instrument was acknowledges{before me The forgoing instrument was acknowledged before me this"4.6 day of 20 aby this \d day of P e"C 20 by e. \ vJ a t �. �—"g c1 lr\,n''.K. 4-d .,J a t-)l, L-c1�c.�v�,,,( Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced rC L Q Produced �H= `) L (Signature of Notary blic-State of Florid (Signature of NotarY Public-Sta a 'dam+_y GNENIS. MARIE G; _ys Commission No.�s � N '�j #G�0�02� Commission ,tip::• MY COMM Qe�mber 16.202 lers i•g EXPIRES:December'-,71) 1 sr i �J_(p�1RESNOtarypubllcunderwn ?; ° BondedThruNotaryPublicr;;, �� REVIEWS F ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17