HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: n • Imo_ Permit Number:
jam: ���_ RECEIVED
Mo MAY 3 0 2019
Building Permit Applicati nn
-ST. Lucie County, Permitting
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
PERMITTYPE:RE_ ROOF
PROPOSED IMPROVEMENT LOCATION:-
Address:
OCATION:_Address
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED"DESCRIPTION OF WORK:
RE-ROOF TO EXSITING DUPLEX f o
"CONSTRUCTION INFORMATION:- "
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/D ors
_Electric _Plumbing _Sprinklers _Generator Woof � I-Pitch
Total Sq. Ft of Construction: /"� Sq. Ft.of First Floor:
Cost of Construction:$ V I UVD Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: 'CONTRACTOR: -
Name Name:REFUGIO ORTIZ
Address: 11 rb 0044IJ 10– &I Company:E&v ROOFING
City: 9L& r)�CrZ e"• State:_ Address:13574 VILLAGE PARK DR
Zip Code: 2;Ld Oi4 -Fax: City. ORLANDO FL State:FL
Phone No. Zip Code: 32837 Fax:
E-Mail: Phone N04-7-738-6320
Fill in fee simple Title Holder on next page(if different E-Mail ROOFINGSOLUTIONS@EANDVROOFING.COM
from the Owner listed above) State or County License CCC1327124
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.
J
-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 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORN RE RECORDING YOU NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signatur o n ractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFORAINIGE COUNTY OF ORANGE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 18 day Of APRIL 20_M by this 18 day of APRIL 204.
by
REFUGIO ORTIZ REFUGIO ORTIZ
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification x Personally Known OR Produced Identification x
Type of Identification And Type of Identification
Produced 6SPRYgs yLmauiSGldtiErr( FL DL
FL DL >.i ,��son NOTARY PUBLIC Produced Aedy, ftAgGutierrez
tJr%•r:vsv �{yq
ra,a v
STATE OF FLORIDA �� „ NOTARY PUBLIC
wU C 1b1
Ccmm#F��A b9 ry Y�� aSTrATE OF Comm#F 96349 FLORIDA
(Signature ary Public-State of Florida) (Signa re o ry Public-St;Ae:_f1florida,)pires 4118
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUP- Q,.R PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW RENEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19