HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 0 Permit Number:
rirj�r "l Ilam
- - Building Permit Application
NOV 2 2019
Planning and Development Services Permitting D e p a rtm e t
Building and Code Regulation Division ,
2300 Virginia Avenue,Fort Pierce FL 34982 .art. Lucie County,E�e
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:ROOFING
PROPOSED IMPROVEMENT LOCATION
Address: 8506 LAKELAND BLVD
Property Tax ID#: 1301-610-0058-000-1 Lot No.18 AND 19
Site Plan Name: Block No. BLK 4
Project Name: Biel's Re-Roof
DETAILED DESCRIPTION OF WORK:
Tear-Off Old Shingles& Replace With New Shingles/Underlayment/Trim
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 X Roof 5 in 12 Pitch
Total Sq. Ft of Construction: 3,800 SF Sq. Ft.of First Floor:
Cost of Construction:$ 13,000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name L 112 A EL Name:Rene Reyes
Address: ILL L--Z\ N 9(.-JD Company:MYFLORIDA ROOFING CONTRACTORS
City: �d 2'[ (� 2.G C� State: L Add
City: 17th Place
Zip Code: Fax: City: Vero Beach State:FI
Phone No. Zip Code: 32960 Fax:
E-Mail: Phone No 772-453-7219
Fill in fee simple Title Holder on next page(if different E-Mail -
from the Owner listed above) State or County License CCC1 326546
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.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X 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
P EDO THE JOB ITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WIT YO LENDER O RNEY BEFORE RECORDING I OTICE ENCEMENT."
1-11A Z ZA
Signa re of Owner/L ssee/ ontractor s Agent for Owner SignaLre of Contractor License H Ider
STAT OF FLORIDA STATF FLORID
COU OF - COUOF
The for ping instrument was acknowledged before me The f going instrument was acknowledged before me
this day of j L�- 20X by this�day of V t-y- 20_Y/ ,by
k?ehc -k eu �
Name of person making stat ment. Name of person making sta ment.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identi 'ca ' A Type of Iden ' icati
Produced h- t G Produced V - �` •
#,4 X114 &4�21a&144- a462�,
(Signature of NM
Public-State of Florida (Signature of No P blic-State of Florida)
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t �?�6 AUDR UMPHREY l} <;Ye�•,
Commission No. �{ t o. - AUDREYB.Nt1�EY
-my !a Commission No
;.: _.: :te MMISSION#GG 300817
` EXPIRES:March 6,2023 Ia �' �4' EXPIRES:March 6 2023
UOnded I t1fU Notary F UNIC ❑•e!wn.rre i IL Ho ded T hr u Notary Public u denvriters ,
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REVIEWS F�tONI` ZONING SUPERVISOR PLANS VEGETATIOOVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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