HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �010
Date: 11/22/2019 Permit Number: I. W L
- Building Permit Application
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: Re -Roof
PROPOSED IM' P'ROVEMENT LOCATION. ,
Address: 286o eagles nest way
Property Tax ID #: 3424-702-0146-000-1
Site Plan Name:
Project Name:
11 QtTAILED DESCRIPTION OF WORK. r ': .
Reroof shingles to shingles Peel And Stick Underlayment
Lot No.27
Block No. 62
16owg VA2
SF
a
CONSTRUCTION INFORMATION
Additional work to be performed under this permit —check all that apply:
_Morhanlcal _Gas Tank _Gas Piping _ Shute. tters _ \A/inrJn:":c/ D^^r5
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof 4 Pitch
Total Sq. Ft of Construction: 2300 Sq. Ft. of First Floor:
Cost of Construction; fi 9825 1 Itilitiac: _ Semler _ Ceptir RUilriing Height:
OWNER/LESSEE .
CONTRACTOR: ;.
Name Maurice geary
Name: roland wiley
Address:2860 eagles nest way
Companv:shorelineroofing
City: port st lucie State: _
Address:1973 sw Glendale st
Zio Code: 34952 Fax:
Citv: Port st lucie State:fl
Phone No:
Zip Code: 34987 Fax:
E-Mail:
Phone N0772-260-9565
E-Mail shorelineroofing@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County LicenseCCC1331170
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
.f �,alue of H � aC :. $7�r-nn �r more, a RECADDED .N ot:.^.P..^.f r..^.mm.�. n�.�. m.�.nt :.�. r.�.^y:A: red.
SUPPLE,MENTALCONSTRUCTI0N LIEN LAW INF ;
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.
ThP following hijilding permit applicatiays_are_eatempt_fr.2rn_und?rgoing_af ll—co_ncurrent rr?vie`nr�_rODm_adcitions,.
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
W R LENDER OR AN ATTORNEY BEFORE RECORDING YOU NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/C ta for as Agent for Owner
Signature of Contractor/Lic se H Ider
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF C",; _
The going in rument was acknowledg d before me
The f rgoing inst ment was acknowledggSL before me
thi; day. 20% by
thi� day o 2(�i) by
Name of person making statern-d4t.
Name of person making statenl4t.
Personally Known OR Produced Identification
Personally Known OR Produced Identification ----
Type of Identification
Type of Identification
Produced
Produced
(S t;. a o1 Notary Public- 'te of Icrida }
u
(Sig. u f.fia',%ow -
NA
INGRAM-RAHMING
Commission No. "YP%, NAINd§MIWMING
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*_ My COMMISSION # GG 27
Com *' �. 5060S I)
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W COMMISSION # GG 275060
er 20, 2022
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Thru Notary Public
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DATE
RECEIVED
DATE
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