HomeMy WebLinkAboutBuilding Permit Application a 1
All APPLICABLE INFO MUST BE"COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: V\01 -d 5aso'
RECEIVED
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• SEF 2 l ?019
Building Permit Application
Planning and Development Services STa Lucio County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE: Roofing -
PROPOSED IMPROVE'MENTIDCATION ;a
Address: 6762 Dickison Terrace Port Saint Lucie FI 34952
Property Tax ID#: 3415-706-0050-000-5 Lot No. 8
Site Plan Name: Kiernan Block No. 3
Project Name: Kleman
DE'AiLED'DESGRIPTION OF'1NORK:
REMOVE EXTING ROOF SHINGLE AND UNDELAYMENT
RE-NAIL ALL PLYWOOD UP TO CODE
INSTALL NEW UNDERLAYMENT/PEEL AND STICK INSTALL NEW OWNE CORNING SHINGLE
CONSTRUCTION INFORMATION:
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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 _Roof 5/12 Pitch
Total Sq. Ft of Construction: 2800 Sq. Ft. of First Floor: 2800
Cost of Construction:$ 15,800 Utilities: _Sewer _Septic Building Height: 8'
OWNER/LESSEE ; COIVTRACTOR.
Name MARIAN KLEMAN Name: MAURICIO ORELLANA
Address:6762 DICKINSON TERRACE Company:ONE CONSTRUCTION &ROOFING
City: PORT ST LUCIE State:L Address: 2766 SW EDGARCE ST
Zip Code: 34952 Fax: N/A City: PORT ST LUCIE State: FL
Phone No.814-342-8665 Zip Code: 34953 Fax:
E-Mail:N/A Phone No772-240-9497
Fill in fee simple Title Holder on next page(if different E-Mail oneconstructionservices@yahoo.com
from the Owner listed above) State or County License CCC- 1330623
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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DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City.. State: City: State:
Zip: Phone Zip: Phone:
FEE IMPLE TITLE HOLDER: _Not Applicable BONDING COMP AN _Not Applicable
Name: Name:
Address: Address:
City.. City:
Zip: Phone: Zi 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Ho_k)_A�CIO 04( HaWA-k UO cvy�_,
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF �\ ' �����_ COUNTY OF
The forrglp15;i;inst�um n was acl nowledged before me The forgoing ins u e t was :knowledgbefore me
this S day of�2 20 6�by this day of �� �(c-2�0 1 by
Name of person making statement. Name of person making statement.
Personally Known `-_011 Produced Identification -Personally Known SCR Produced Identification
Type of Identification Type of Identification
Pro uced Produced
PAQl_FTTFRLAlR-AlFyANnFR
(Signature of Nota fat@ FTJ�dh�IR-ALEXANDER (Signature of Note ry. " z�fafi�ttff1FPdtd:a-)State of Florida
.7� tary Public-State of Floridan° mmission #FF 995699
Commission No. C a�� �V QFC ommisjg@aj9 FF 995699 Commission No. °� o F omm.E�l8&a1Jep 6,2020
OF My�,��' My Comm.Expires Sep 6,2020 fi _
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DATE
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