HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1/2/19
Permit Number:
- 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 X
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 336 SE TRANOUILLA AVENUE, PORT ST. LUCIE, FL 34983
Legal Description: RIVER PARK - UNIT 4 BLK 38 LOT 24 (MAP 34/28N) (OR 3558-1485)
Property Tax ID #: 3419-530-0175-000-0
Site Plan Name: FARHAT REALTY & INVESTMENTS INC
Project Name: REROOF
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
TAKE OFF EXISTING ROOF AND REPLACE WITH NEW SHINGLE ROOF
Lot No. 24
Block No. 38
CONST ".JCTION INFORMATION:
Additional work toe er orme under this permit — check a apply:
HVAC F] Gas Tank F]Gas Piping _ Shutters ❑ Windows/Doors
11 Electric ❑ Plumbing 11 Sprinklers Generator Roof /12 Roof pitch
Total Sq. Ft of Construction: _.
Cost of Construction: $ 11,900
Sq. Ft. of First Floor: _
Utilities: []Sewer[]Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name FARHAT REALTY & INVESTMENTS INC
Name: LEE DINENBERG
Address: 1181 S ROGERS CTR, STE 28
Company: FREEDOM ROOFERS
Address: 5575 US HWY 1, STE 1 & 2
City: BOCA RATON State: FL
Zip Code: 33487 Fax:
Phone No.806-236-6646
City: VERO BEACH State: FL
Zip Code: 32967 Fax: 772-217-4459
Phone No. 772-318-4600
E -Mail: greatroofs@freedomroofers.com
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CCC1330900
If value of -onstruction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
Name: _
Address:_
City:
BONDING COMPANY: Not Applicable
Name:
Address:
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
commen-;ng work or recording your Notice of Commencement.
Rev. 8/2/17
Signat[ire of Owner/ Lessee/Contractor as Agen for Owner
Sign ure of Con c r c Hold
STATE OF FLORIDA
STATE OF FLORIDA
COUNTYOF INDIAN RIVER
COUNTY OF ,rrI,IAN, 41,."
I
The forgoing instrument was acknowledged�pefore me
The forgoing instrument was acknowledgedbefore me
//
this 2 day of JANUARY 20 by
this 2 day of JANUARY 20� by
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
d
Prod
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(Signature of Notary Public- St e o„• arl a NETTEMCGR4RY
(S nature of Notary Public S ANNE MCGRORY
Notary Public -State of Florida
cco�sss5 • dnU
; ,,` "Y 4�; .: Notary Pub is -State of Florida
Gco�ssss ':
Commission No. Eal) Commission#CG076355
My comm. Expires Feb 23, 2
Co mission No. ��j�, ;. (S ea+mission4GG076355
21 ;➢oR My Comm. Expires Feb 23, 2021
.? o r`"••' Bonded through National Notary
A sn. R , „ ,k5'," y Assn
Bonded through
REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17