HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
RECETVIF-D
Building Permit Application
SEP 242019
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 X
PERMIT TYPE: RE ROOFING
PROPOSED IMPROVEMENT LOCATION::
Address: 7502 PALOMAR ST
Property Tax ID#: 1301 602 0008 000 1 Lot No.8
Site Plan Name: LAKE WOOD PARK UNIT 2 Block No. 10
Project Name:
DETAILED DESCRIPTION OI'VORK
RE ROOF SHINGLE14
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CONSTRUCTI.Q(V INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters Z Windows/Doors
Electric _Plumbing _Sprinklers _Generator (/ Roof 3 -r__ Pitch .
Total Sq. Ft of Construction: loo Sq. Ft.of First Floor: I Zy g
Cost of Construction:$ Co S 90 Utilities: —Sewer /Septic Building Height: /571
,OWNER/LE5'SEE CONTRACTOR:
Name JBM PROPTERIES LLC Name:ADDERLY,TODD
Address:12723 ASHLEY FALLS DR Company:ADDERLY DEVELOPMENT INC
City: SAN DIEGO CA State:_ Address:5079 N DIXIE HWY,#258
Zip Code: 92130 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.
'S'UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIQN'
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 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 J9B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR ORA TTORNEY BEFORE RECORDING OUR NOTICE qf COMMENCEMENT."
S' ture of Owner/Lessee/Contractor as Agent for Owner Signature of Contrr0/License-RoIder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF BROWARD COUNTY OF BROWARD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this_day of 9124119 20_ by this day of 9/24/19 ,20_ by
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Name of person maInd emen
. Name of person making statement.
e..• -? GAIL ROBINSON �� � �,•sF
Personally Known =�. AVAgNM 1NcgatFEIR21240 Personally Known OR Produced Identification
Type of Identificati qF'v � EXPIRES October 14,271'-1-- Type of Identification
Produced (7G')343.015� FlwdaNOtar .Sorvlce.com Produced
AQy�LK O Q.
(Signature of Notary Public-State of Florida) (Signa ure of N to Public-State of Florid :A
1�
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
Rev.2/7/19