HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1�-� q' 1� Permit Number: 1
RECEIVED
Building .Permit Application
NMIMMINM M
DEC 0 9.2019
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:, 66River.Palm Dr Fort Pierce, FL 34946
Legal Description: RIVERVIEW MANOR BLK CLOT 27 (OR684-1650: 2888-2613)
Property Tax ID#: 1408-703-0093-000-1 Lot No.27
Site Plan Name: Block No. C
Project Name: Sammons Re-Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK" `
Remove and replace existing roof covering
Extreme Metal 5V Gimp - 20378.6
Titanium PSU 30 - FL11602-R9
CONSTRUCTION INFORMATION.:
Additional work to be nerformed under this permit-check all that appy:
11HVAC I_I Gas Tank ❑Gas Piping ElShutters Windows/Doors
Electric D Plumbing Sprinklers Generator Roof 5/12 Roof pitch
Total Sq. Ft of Construction: 970 S . of First Floor: 970
Cost of Construction:$ 5,800 Utilities]Sewer Septic Building Height:
01NNER/LESSEE:- - CONTRACTOR: .'
Name Linda L_Sammons Name: LARRY NEESE
Addres..1019_'IER PALM DR Company: LARRY NEESE, LLC
City: Fort Pierce State:FL Address: 3401 S. US HWY 1
Zip Code: 34946 Fax: City: FORT PIERCE State:FL.
Phone No.P: (772)216-9979 Zip Code: 34982 Fax: 772-361-6581
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 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-re idential use
WARNING TO OWNER:Your fail to Record a Notice of Commencement may result in your ying twice for
improve your prop .A Notice of Commencement must be r ded and po ed on the jobsite
befor a 7sorrkorriciordingvou
spectf you intend to obtain financing, consul lth le der or an ttorney before
com
WOE
r Notice of Commencement.
Signat a of O her/Le see/Contractor as Agent for Owner Signature of C tractor/Licen Holder
ST TE FLORIDA STATE OF FL
C Y OF St.Lucie COUNTY OF St Lucie
The forgoing instr ent was acknowledged before me The forgoing instru ent was acknowledged before me
this�—day of ei! 20B by this�day of o P. .m : by
Larry C Neese Larry C Neese
Name of per§on making statement Name of person making statement
Personally Known Of OR Produced Identification Personally Known `OR Produced Identification
Type of Identification Type of Identification
Produced Produce
\�DGJ 1 )�
(Sig ure of o ary Public-State of Florida) (Signature of Nota rP 'lic-State of Florida)
I , J I
Commission No. S a mmission No t�of Florida
otary ubiic State of Florida ry pub
Amy N Wood Amy N Wood
v My Commission GG 241645 My Commission 22 241845
a
REVIEWS FRONT O N R LANS VEGETA E URTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17