HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: May 1, 2019 Permit Number:
- - T = RECEIVED
Building Perm it.Applicatio FEB p ?0��
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
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: 5213 Palm Dr Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 07- BLK 49 LOT 37 (MAP 34/02S) (OR 1393-917),
_ Property Tax ID#: 3402-608-0339-000-4 Lot No.37
Site Plan Name: Block No. 49
Project Name: Amland Flat Portion Re-Roof
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPTION OF WORK:
Remove and replace only flat portion of roof.
Polyglass Modified Bitumen : FL1654-R24
CCQ,NSTRUCTION-IN FORMAT[ON: .
Additional work to be nertormed under this permit—check all thnt appy:
❑HVAC Gas Tank Gas Pi in _Shutters Windows Doors
11 Electric 0 Plumbing Sprinklers 1:1 Generator R1 Roof 0.125 Roof pitch
Total Sq. Ft of Construction: 765 S . Ft.of First Floor: 765
Cost of Construction:$ 4500 Utilities:Sewer Eheptic Building Height:
OWNER/LESSEE:--
-CONTRACTOR: w
Name Marian F Amland Name: LARRY NEESE
Address:5213 Palm Dr Company: LARRY NEESE, LLC
city: Port Saint Lucie State:FL Address: 3401 S. US HWY 1
Zip Code: 34983 Fax: City: FORT PIERCE State:FL.
Phone No. (772) 332-0683 Zip Code: 34982 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: CCC 1330608
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: 3401 S.US HWY 1 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attor before
commencine work or recording our Notice of Commencem
Signa ure of Own ee/Contractor as Agent for Owner SidQxure ofCoatratf
or/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF St.Lucie COUNTY OF St Lucie
The o oing instru t as acknowled d before me The forgoing instru t�as acknowledged ?efore me
this hay of 2 by thi day of -Q.I' 20 v by
1 a,lrr� 1 arry ntew.-
Name of p r n making statement Name of p on making statement
n
Personally KnowOR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
— ()uy In , wno Pjiw n
(Signature of No y P (Signature of Not r 01 a
n teary Public.State of Florida -Notary Public State of Florida
Commission No. l� J3 rvy�� Commission NO. RAY N od
My Commission GG 241645 My ComGG 241845
a r Expires 07/2512022 � d Expires 07125/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17