HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: y
�\`a�l\� Permit Number: \a,\`��dy'�3
Wie, RECEIVES
Building Permit Applicatio I
Nov 3 �Ig
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 APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION:
Address: 3500 SHINN RD FORT PIERCE, FL. 34945 (building 1)
Legal Description: 30/31 35 39 THAT PART OF SE 1/4 OF SEC 30 35 39 LYG S AND W OF 11 MILE CREEK AND E OF SHINN RD RNV-LESS RD AND CANAL RS/W
AND LESS MPDAF:FROM SW COR OF SE 1/4 OF SEC 30 RUN N 00 DEG 21 MIN 46 SEC W ALG 1/4 SEC LI 2042.03 FT,TH S 83 DEG 11 MIN
Property Tax ID#: 2330-410-0000-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Twenty Twenty Grove Re-Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Remove existing roof covering and replace with new roof covering
Polyglass Modified Bitumen : FL1654-R24
[CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit—check all that appy:
OHVAC Gas Tank ❑Gas Piping Shutters Windows/Doors
Electric ❑Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 1200 SFt.of First Floor: 1200
Cost of Construction:$ 6750 Utilities: L_ISewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Twenty-Twenty Groves Inc Name: Lar"
r"
Address:PO Box 14049 Company: L�NEESE, LLC
City: FORT PIERCE State:FL Address:(51401 'S. US "W\f _-L
Zip Code: 34979 Fax: City: q 'rt Q I e r(1R_ State:FL.
Phone No. (772) 643-8261 Zip Code: 3498 Fax:
E-Mail: Phone No. 772-361-6580
Fill in fee simple Title Holder on next page(if different E-Mail: larryneeseroofing@gmail.com
from the Owner listed above) State or County License: CCC1330608
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx 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 the permit 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 fail to Record a Notice of Commencement may result in your paying twice for
improvements to your proper . A Notice of Commencement must be recorded and po d on the jobsite
before the firs inspection.prop/
ou intend to obtain financing, consul lender or attorney before
comment' w rk or recor in our Notice of Commencemen
Signature Own Lessee/Contractor as Agent for Owner Signature of ontractor/L' ense Holder
COU STAT O OF ORIDA ��. �[ 1�� COUNTSTATE OY OF FL A LVI�I�
The forgoing instrument was acknowledge before me The fro�r Ding instr ment was acknowledge before me
this 1�day of tQ0V• ,20n by this J�.L day of w. 20LI by
Name of pers n making statement Name of pers n making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
\�Mj ( I k i " -0 .
(Signature of Nota P lic-State of Florida) (Signature of Notary P 'c-State of Florida)
Commission No.C-1 ea mmission NoC..!
Notary ubiic Stat®of Florida ,err Notary ublic tete of Florida
Amy N Wood Y Am N Wood
v My Commission GG 241645 • 6�}�1�19►1 Cid 241t?46
CW F
REVIEWS FRONT O P R S PLANS VEGETATI I G E
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17