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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .
Date: � t���T Permit Numb RECEIVED
.
JAN 2 7 2020
Building Permit Applic e County, Permitting
Planning and Development Services
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:ROOF
PROPOSED lMPR01/EMENT`LOCATION w M t '
Address: 6618 ALEMENDRA STREET FORT PIERCE FL, 34951
Property Tax ID#: 1306-500-0363-000-9 Lot No.18
Site Plan Name:.SPANISH LAKES FAIRWAYS Block No. 75
Project Name: SELACK
DETAILEDDESCRIPTiON OAF WORK' Fx t � f � ` ' r r
RE ROOF SHINGLE TO SHINGLE
CONSTRUCTI(?NINFORMATION:'E3"
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 5112 Pitch
Total'Sq. Ft of Construction: 3000 Sq. Ft.of First Floor: 3000
Cost of Construction: $ 9000 Utilities: —Sewer _Septic Building Height:
Name BARRY SELACK _ Name:EDWARD LECHNER
Address:6618 ALEMENDRA STREET Company:EDIFICIUM CONSTRUCTION
City: FORT PIERCE State:_ Address:1215 CASTAWAY BLVD
Zip Code: 34951 Fax: City: VERO BEACH State:FL
Phone No. Zip Code: 32963 Fax:
E-Mail: Phone N0772 643-4513
Fill in fee simple Title Holder on next page(if different E-Mail EDI FICIUMROOFING@GMAIL.COM
from the Owner listed above) State or County License CCC1331308
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.
SUPPLEMENTgA� C.aNSTRUCTi,tJN'�L1, N LAW INFO 'ONfF�
.y fa"77'
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 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,wails,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 110 OBTAIN FINANCING, CONSULT
WITH YOUR LEND9"R AN ATTORNEY BEFORE RECORDING YOUR NOTICE 0 C MMENCEMENT."
i
Signature of Owner/Le ee/Contractor as Agent for Owner Signature of Contractor se Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 2:7!d A AJ I j/ ,5X COUNTY OF r,4-//) 4" A4, I kZe
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of [#A120�by this�day of &d 2021, by
t ame of person making statement. Name of person making statement. .
Personally Known X_ OR Produced identification Personally Known V OR Produced Identification
Type of identification Type of Identification
Produced Produced
(Signatur of Notary Public--State of Florida} (Signat a of Notary Public-State of Florida}
Commission No.��- L C /�l/ se, Notary Public St tg9� ' sio No-ems' �AC�! `+ l S •�,� Notary Pubhc to of Flor,c
. Randy G Bias Qyjhandy G Gia
a My Commission G 302181 My Ctlttlttll5 302181
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FRONT ZONING SUP R VEGETATION SEA TURTLE M
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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