HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a�1� Permit Number:
DECEIVE®
- Building Permit Application JU`� 2 291
Planning and Development Services �.
irip •,n,lntr, Permitting
Building and Code Regulation Division ---
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential xx
PERMIT TYPE: ROOFING RESIDENTIAL
PROPOSED IMPROVEMENT LOCATION:
Address: 3238 EAST LAKE DRIVE
Property Tax ID#: 2427 701 0046 000 3 Lot No.5
Site Plan Name: Block No. 3
Project Name:
DETAILED DESCRIPTION OF WORK:
RE ROOF SHINGLE AND FLAT
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply: J
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof 3.5/12 Pitch
Total Sq. Ft of Construction: '44M!2: /, SS—O Sq. Ft.of First Floor: 1575-0
Cost of Construction:$ 6000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name 3238 EAST LAKE DRIVE Name:ADDERLY,TODD
Address: 552 se crescent ave Company:ADDERLY DEVELOPMENT INC
City: Port Saint Lucie State: fl Address:5079 NORTH DIXIE HWY #258
Zip Code: 34984 Fax: City: OAKLAND PARK State:FL
Phone No. 7868381595 Zip Code: 33334 Fax:
E-Mail: Phone No 954 445 4078
Fill in fee simple Title Holder on next page(if different E-Mail adderlydev(Pgmail.com
from the Owner listed above) State or County License CCC 1327886
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.
SUPPLEMENTAL CONSTRUCTION"L[EN LAVH 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 ATTORNEY BEFORE RECORDING YONR NOTICE OF OMMENCEM "
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contra ctor/L cense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF BRowARD COUNTY OF BRDWARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 17 day of JUNE 2019 ,20_ by this 17 day of JUNE2019 200_ by
�IGVC Cis ! oVD A296144sll
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification FL ID Personally Known OR Produced Identification FL ID
Type of Identification/ Type of Identificatio
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Flo ' R pGg2
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Commission No.
Gp►11.( T��Sp9272g0 . Commission No.
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DATE
RECEIVED
DATE
COMPLETED
ev.Z/7119