HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -
Date: Permit Number:19D -
_0 I ' - RECEIVED
Building Permit Applicatiop JUL 1 1 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 XXX
PERMITTYPE:
PRQPgSED Ilti%I,PRQUEMENT LOCATIOM1I .,.
Address: 5012 BARCELONA AVE
Property Tax ID#. 1431 703 0087 000 8 Lot No.1, 2, &3
Site Plan Name: Block No. 3
Project Name:
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RE ROOF SHINGLE
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator V-Roof 4 Pitch
Total Sq. Ft of Construction: Soo Sq. Ft.of First Floor: .72 (--
Cost
7 (oCost of Construction:$ ��3 7S Utilities: —Sewer _Septic Building Height: I
C?WNE`R/LESSEE U 'CONTRACTt}R ,'°`
Name AMY OSBORNE Name:TODD ADDERLY
Address:5012 BARCELONA AVE Company:ADDERLY DEVELOPMENT INC
City: FT PIERCE State:_ Address:5079 NORTH DIXIE HWY#258
Zip Code: Fax: City: OAKLAND PK State:FL
Phone No. 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@yahoo.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.
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UpPL,EMENIAL UCTION LIEN LAW�INFt
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DESIGNER/ENGINEER: _Not�Applicab ` _..,.. > .,�m._ ..• . , _ . . �.- z. .� _. . _ .
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 thepermit 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 LEND AN ATTORNEY BEFORE RECORDING Y UR NOTICE OFA COMMENCEMENT."
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e of Owner Lessee/Contractor a's Agent for Owner Signa ure of Contracto License Holder
STATE O RIDA STATE OF FLORIDA
COUNTY OF BROWARD COUNTY OF BROWARD
The f rgoing instruqpentas acknowledgf before me The or oing instrum n was acknowledgedfkefore me
this_4o day of. �, 20 I j- by this day of 20 .
ll vn�^� 1' 1-9(666 ��/ .
Name of person making statement. Name of person making statemen .
Personally Known Le—OR Produced Identification Personally Known_��OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/7/19