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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: I�.1� Permit Number: IZa RECEIVED Building Permit Application . JAN o 2 2019 Planning and Development Services Building and Code Regulation Division ST. LuMo CONnty, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: Roof PR®POSE© IMPROVEMENT LOCATION: Address: 419 European Ln Fort Pierce, FI 34982 Legal Description: PALM GROVE S/D BILK H LOT 7(0.12AC)(OR 1029-2866: 1189-2939) Property Tax ID#: 3410-503-0217-000-6 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: WiiIfED ©E R OPTION �+ F WORK: Re-roof Shingle to Shingle C'®NSTRUCTIONINFORM KIAATION: WON Additional work toe e orme under this permit—check a appy: HVAC Ei Gas Tank ❑Gas Piping _Shutters a Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof ® Roof pitch Total Sq. Ft of Construction:Q1 OD.°' S . Ft.of First Floor: Cost of Construction:$ ,d,USO Utilities:cn Sewer Septic Building Height: 0V1/NC�R/LE-�SS,EE: CONTRACTQR: Name Kenneth G Haight Name: Roland Wiley Address:419 European Ln Company: Shoreline Roofing City: Fort Pierce State:Fl Address: 1973 Glendale St Zip Code: 34982 Fax: City: Port Saint Lucie State:FI Phone No. Zip Code: 34987 Fax: E-Mail: Phone No. 772-206-9565 Fill in fee simple Title Holder on next page(if different E-Mail: Shorelineroofing@yahoo.com from the Owner listed above) State or County License: CCC1331170 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL @QNSTE2'l1CTINS LIEN LAW INFORMATION,: 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:1973 Giendale St 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. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contrac r s Agent for Owner Signature of Contractor/License Ho der I STATE OF STATE OF FLORID �� l COUNTY OF ORIDAO1� l COUNTY OF The Wing instr t was acknowledged before me The fo going instr ent was acknowledged before me thisay of _ 201(� by this of{11 �,�. 20 by Name of persoj�'m c(J' g statement Name of persf�ri maki fi statement Personally Known V OR Produced Identification Personally Known V OR Produced Identification Type of Identification Type of Identification Produced Produced bcqdd &no­ (Signature f Notary Public-State of Florida) (Signature of ary Public-State of Florida) }LY Py �,,�,,,4 . BRANDYM00 E ovPys, BRANDYM00 E G1o2.�3 `" (� Commission No.36102N , � Commission Zg3gnmission No� � 2�3 I o ' I) Commisslorlfi6G 0 9 a Expires May 9,2(21 " �? o� Bonded tnru Budget h ��• Expires May 9.2 2 ofFti• a t atary 7/f0'P`oq. BondedTlwBwWdtdo ka REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17