HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� 1 \ Permit Number: z\gw '- a�`�
\
RECEIVED
'COUNTY
Building Permit Applica tionJUN 11 2019
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:ReRoof - S�
.PROPOSEkIMPROVEMENT,LOCATION
Address: W\.A �1 SAI SZ
Property Tax ID#: 3410 " �56S- 03a-f? "C66 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION Of_WORK:,
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:
OVVNERAES, E: CONTRACTOR:
Name Q Name:Roland Wiley
Address:3'73 &44,14- 144,,— Company:Shoreline roofing
City: ;Ef State: Oct Address:1973 sw Glendale st
Zip Code: N909 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 CCC1331170
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.
SUPPLEMENUW"" dhlSTRUCTION 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
WIT R ENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Signature of Owner/Lessee/Co tactor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI A STATE OF FLORIDA
COUNTY OF S k. -2 COUNTY OF '��• �-v
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_\_�,_day of _J" .20__n by this A_L day of 20_�J by
Name of person making statement. Name of person making statemen .
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 Florida) (Signature of Notary NbS
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REVIEWS FRO ",Eo: f UPERVISOR PLANS VEGE ION SEA TURTLE MANGROVE
COUN W REVIEW REVIEW REVIEW REVIEW REVIEW
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