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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I l—�D I h9 Permit Number: 19 11 O
-7-1
RECEI�lED.
' � NOV 0 5 2019
- Building Permit Applicati n
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED'IMP:ROVEMENT;LOCATIgN
r_
Address:
Property Tax ID#: _ ��4- 5 b - (z Lq - N-0 3 Lot No..-5-4 (0
Site Plan Name: Block No. I h
Project Name:
DETAILED DESCRIPTION OF'WORK
ex I r C L ; /
0 CJ
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 --Rauf— 3 Pitch
Total Sq. Ft of Construction: _ Sq. Ft.of First Floor:
Cost of Construction:$�, �,��. Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name Namc.ALChcv- Q C.v�
Address: 42- Compan14 0-6
City: k Q fC State'_ Address:
_,2) `�1
Zip Code:
Fax: City:_ e"o"6e Ifs... Stater
Phone No. Zip Code:J L0_q' � Fax:
E-Mail: Phone No 'E�_Q _LQ.I.
Fill in fee simple Title Holder on next page(if different E-Mail 0 Le_ �
from the Owner listed above) State or County License C S
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,UPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION ' L,
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 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:"
Si nature of Own6rJ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID , STATE OF FLOM
COUNTY OF�� • ,kU C-1 e- COUNTY OF (z -t. lu
The for o'ng inst ument was acl nowledg before me The for oing instr ent was accnowJedg efore me
this day of� 20 by this day of V- by
Name of person m,akingstatement. Name of person making statement.
Personally KnowrlJ/OR Produced Identification Personally Known L. /ORProduced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of FI' d I�dg1t� to 0Ito« (Si ature of Notary Public- tate of Florida I
Commission No. " e��' ` ���i ��!��a Com ission No. H ;,,OG
tride
ire a1 912 ` sAo�: y�U�r;r18REVIEWS FRONT NING SUPERVISOR PLANS VEGETATION SEATURTLE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.71/7/19
R �FIV90
NOTICE OF COMMENCEMENT'
TO BE COMPLETED WHEN CONSTRUCTION VALUE EXCEEDS$2,500.00 NOV 0 5 2019
OR WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS$7,500.00
PERMIT#: TAX FOLIO#:3404-501-0064-000-3 ST. Lucie County,_Permitting
State of Florida,County of Indian River,the undersigned hereby gives notice that improvement will be made to certain real property,and in
accordance with chapter 713,Florida statutes,the following information is provided in this notice of Commencement.
1. LEGAL DESCRIPTION OF PROPERTY(AND STREET ADDRESS IF AVAILABLE):
WHITE CITY BLK 10 LOTS 5 AND 6 AND N10 FT VAC ALLEY ADJ ON S (0.29 AC)
2. GENERAL DESCRIPTION OF IMPROVEMENT:
Re Roof
3. RDOWNER INFORMATION or CLESSEE INFORMATION (If Lessee contracted for the improvement)
a. Name: White Citv Rentals LLC ;U o-n y
M;UF>0
Address: 5006 Oleander AVE Fort Pierce, FL 34982 0 o
b. Interest in property: Owner -0 _
z worn
c. Name and address of fee simple title holder(if other than owner): c?w m in
A N
.9 0
�DCCr
4. CONTRACTOR: _ coo zi n
a. Name: Richie the roofer&Co Inc {M
Address: 90513th st sw Vero Beach Fl.32962 x
b. Phone number: 772-473-6197 CO
�`°
S. SURETY COMPANY(IF Applicable,a copy of the payment bond is attached): g m
a. Name&Address:
b. Phone number: Bond amount: CD a 06. LENDER/MORTGAGE COMPANY: z 1
0 n
a. Name&Address: o
b. Phone number:
7. PERSONS WITHIN THE STATE OF FLORIDA DESIGNATED BY OWNER UPON WHOM NOTICES OR OTHER DOCUMENTS 1
SERVED AS PROVIDED BY SECTION 713.13(1)(a)7.,FLORIDA STATUTES:
a. Name&Address:
b. Phone number: fax number:
8. IN ADDITION TO HIMSELF OR HERSELF,
a. Owner designates of ti
a copy of the lienor's notice as provided in section 713.13(1)(b),Florida statues.
b. Phone number:
9. EXPIRATION DATE OF NOTICE OF COMMENCEMENT:
(THE EXPIRATION DATE IS ONE(1)YEAR FROM THE DATE OF RECORDING UNLESS A DIFFERENT DATE IS SPECIFIED).
WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713,
PART I,SECTION 713.13,FLORIDA STATUTES AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT.
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING AND THAT THE FACTS IN IT ARE TRUE TO THE BEST OF MY
KNOWL D BELIEF(SECTION 92.525,FLORIDA STATUTES
SIGN4T—URE'0'FOWAiior LESSEE or OWNER'S AUTHORIZED OFFICER/DIRECTOR/PARTNER/MANAGER
owner
SIGNATORY'S TITLE/OFFICE
THE FOREGCUNG INSTRUMENT WAS ACKNOWLEDGED BEFORE ME THIS. DAY OF1,�jL&-2019 , BY:
larl. US& -
AS owner FOR
NAME OF PERSON TYPE OF AUTHORITY NAME OF PARTY ON BEHALF OF WHOM INSTRUMENT WAS EXECUTED
OPERSONALLY KNOWN OR []PRODUCED IDENTIFICATION TYPE OF IDENTIFICATION PRODUCED
-0"Aamda'�3rendqa arna& x 3"'ej s C7-
NOTARY SIGNATURE NOTARY PRINTED NAME NOTARY SEAL
+?A Not"public Statevf Florida
Amanda P SartclG 21
My�olnINOV0n GG 211256
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