HomeMy WebLinkAboutBuilding Permit Application 1 S I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,t5'ag- ri Permit Number:
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Iiiiiiiiiiiilliellialitiallii Building Permit ApplicationMArz 10' 9
Planning and Development Services Permittin
ivision
2300Building
Vi giniaCAvenue,,Fort P ee Regulation r)ce FL 34982 St' '9�C°a yen.
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMITTYPE:RE ROOF j
PROPOSED IMPROVEMENT LOCATION
Address: 2202 ELIZABETH AVE FORT PIERCE, FLORIDA 34982
Property Tax ID#: 2428-604-0033-0004 Lot No.19
Site Plan Name: Block No. 21
Project Name: WILSON
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE SHINGLE WITH SHINGLE
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical —Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof 3:12 Pitch
Total Sq. Ft of Construction: !/O 6 ScQ F) Sq. Ft.of First Floor:
Cost of Construction:$ 5500 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR;
NameSUSAN WILSON Name:EDWARD LECHNER
Address:2202 ELIZABETH AVE Company:EDIFICIUM CONSTRUCTION LLC
City: FORT PIERCE State:_ Address:1215 CASTAWAY BLVD II
34982 VERO BEACH FL
Zip Code: i Fax: , City: State:
Phone No. Zip Code: 32963 Fax:
E-Mail: I Phone No772 6434513
Fill in fee simple Title Holder on next page(if different E-Mail EDIFICIUMROOFING@GMAIL.COM
from the Owner listed above) State or County LicenseCCC1331308
II
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION 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: 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER R AN ATTORNEY BEFORE RECORDING YOUR NOTICE 0' OMMENCEMENT."
ec / C�SL` A
�IA.+ W C\v1".�M` • 1�. <X). {-1-01
Signature of Owner/Less--' Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFritibm/ti R/t/EX COUNTY OF _73)?)/0,j Aver
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisa . day of in4 Y ,204. by this. day of mQy ,20/9 by
Edward 1Lechher• Edw4 .d 4[c-tiher-
Name of person making statement. Name of person making statement.
Personally Known ✓ OR Produced Identification Personally Known I/ OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature."4 Notary Publi
(Signature t.f Notary
40.Y.�g KIMBERLY E.MASSUNG
KIMBERLY E.MASSUNG ,�;
o
Commission No. _'d a Con alin#FF 214584 Commission No. 4=- __ Commission E051584
-e5:q Expires July 15,2019 {` '.• .Q Expires July 15,2019
',a M1°,:• Bonded Thru Troy Fainlnsuranco 800385-7019 } oF. .•• Bonded Thru Troy Fain Insurance 800385-7019
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley. 2/7/19