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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \ \1 \`� Permit Number: Fln ECEIVE® COUNTY N0�9 -0- BuildingPermit A lica _pp CSN 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 PERMIT TYPE:ReRoof PROPOSED IIVIPROVEMENTjLO`CATIONs_; ; 5: Address: -'-1©l Z QAA/L4- FA f El , -34Ct% � Property Tax ID#:3y1 O- �j0`3-t��30- ��"L4 Lot No. Site Plan Name: Block No. Project Name: i 5 4 ..G " DETAILED DES�CRIPT)ON O.F, RK reroof shingles to shingle, peel and stick underlayment 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 5 Pitch Total Sq. Ft of Construction: 3000 Sq. Ft.of First Floor: Cost of Construction:$ 10000 Utilities: —Sewer —Septic Building Height: 01NNER/LESSEE r _ CONTRACTOR: Name Name:RolandWiley Address:LkO\ C3,,QA4✓0_ Vfai� Company:Shoreline roofing City: 'FBF State: 19 Address:1973 sw Glendale st Zip Code: 3`-lA$2. Fax: City: port st luice State:fl Phone No. Zip Code: 34987 Fax: E-Mail: Phone No772-260-9565 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 CM 331170 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. � � ���,�� � _i.s:'.4' �c+i'�-`:i....� � � � A 4$4 L'4`' ,.� is � �• ��i.. _.'�..} -?'+4't� ��_v...�=3 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 installationhas 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 WIT R ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." C2T LOS— Signature of Owner/Lessee/Co ractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIpA STATE OF FLORIDA COUNTY OF S k. 'PZ, COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this _day of J n e .20_A by this_V�,_day of "s�v��_ ,20 lJ by Y.A, 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 Produced L L (Signature of Notary Pu lic-State of Nota of Florida) (Signature ryE�as ( g Notary 9�41f )G pFjU`1N N#GG p22023 ���EG1V 0�3 •;vouo•., V4A15510, X020 Commission No. V�-�fJ MY MFS`D510N#QGg?20 Commission No. Y RES:fle�pUndetwritets 0 b e Mets _3; oa d 11o12N =,c'?'�ru2�., G �S: �otiblt4V�U� :"9! �•o;.' BOndg hN REVIEWSFRO =; os� UPERVISOR PLANS VEG ION SEA TURTLE MANGROVE COUN W REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2/7/19