HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE. ACCEPTED
;Date:
Permit Number: 0 e
90
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 X
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
"PROAOSED''INIPROVEMENT''°LOCATION
Address:
Property Tax I D #: (4 5& -)Q '0 41. V UU � � Lot No.
Site Plan Name: �_ Block No.
Project Name: /f &M le* �—R&I
DETAILED DESCRIPTIQN OF..WORK
Re -Roof. l i°QY()Fr D161 Risk' w0b new sAinwa 9- )e&6 ve.)-4s. _
CONSTRUCTION, -INFORMATION:
Additional work to be performed under this permit —check all that apply:
—Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric —Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:- l� 1
Cost of Construction: $ Q�
Sq. Ft. of First Floor: _
Utilities: —Sewer _Septic
Windows/Doors
Roof Pitch
Building Height: /Lf
OWNtR/LESSEE: '.:
CONTRACTOR:
Name - - i)
Name: Robert Donovan
Address: APJ glud
Company: Total Home Roofing
City: I wien &A&I State :L
Address: 597 Haverty Court, Suite 40
City: Rockledge State: F
Zip Code:-�C/q:Jr-7 Fax:
Phone No. 9511- 3360'33 267
Zip Code: 32955 Fax:
E-Mail:
Phone No 321-452-9223
Fill in fee simple Title Holder on next page (if different
E-Mail Christa@throofing.com
from the Owner listed above)
State or County License CCC1330489
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: CLNotApplicable
MORTGAGE COMPANY: C!- Not Applicable
Name:
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: GL- Not Applicable
BONDING COMPANY: Not Applicable
Name:
Na me:
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 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 .DOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature
STATE OF FLORIDA
COUNTYOF hNcir\oC1
The forgoing instrument was acknowledged before me
this day of :i�ZNi 20a by
Name of pers making statement.
Personally Known OR Produced Identification - X
Type of Identification
Produced���\
Lint, A MY UUNCAN QUil
(Signature of tary Public- t t i a
R otaryr Public, State of F6
Pommission# GG 17b4
Commission No. () (e%Comm. expires Dec. 21,
REVIEWS
RECEIVED
COMPLETED
se Holder
STATE OF FLO I A
COUNTY OF
The ing instru ent was acknowledged before me
r
this day of t 20eW by
Robert Donovan
Name of person making
statement.
Personally Knownc>4 OR Produced Identification
Type of Identification
Produced
of Notary Pu
No.
COUONTER I ROEVIEW I NING S REVIIEWNT OR I REVIEW PLANS I VEGETEVIEWON
CHRIS�TA•LYN SALMONSON
MY 92MMM� .SION # FF 969903
E March 10, 2020
Bonded Thru Notary Public Underwr
SEATURTLE I MANGROVE
REVIEW REVIEW