HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOF APPLICATION TO BE ACCEPTED
Date: �l a.5� = Permit Number: adc�a-O�5
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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:
'.PROPOSED IMPROVEMENT LOCATION:
Address: (.!1 �(t�_
Property Tax ID#: Lot No,
Site Plan Name: Block No.,
Project Name:
DETAILED DESCRIPTION OF WORK:
Re-Roof (Q 9- Ce-gqo le �W . H Z
T Vi�/je n � GjO� ahig ltd t e 7a� f /Zt,p
CONSTRUCTION;INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing
i _Sprinklers —Generator ( Roof Pitch
Total Sq. Ft of Construction: � `T�� Sq. Ft. of First Floor:
Cost of Construction:$ Utilities: —Sewer —Septic Building Height: lJr
j OWNER/LESSEE: CONTRACTOR:
Name LfAii Cab Name: Robert Donovan
Address:&y060 P6"10(" �Gi'/Ctt Company: Total Home Roofing
city: Ori � rc-P Stale: `L Address: 597 Haverty Court, Suite 40
Zip Code: qs/ Fax: City: Rockledge State:' FL.
Phone No.!-ya '-oZQ,2-- $°SOS Zip Code: 32955 Fax:
E-Mail: Phone No 321-452-9223
Fill in fee simple Title Holder on next page(if different E-Mail ChristaCCthroofing.com
from the Owner listed above) State or County License CM 330489
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: Not Applicable MORTGAGE COMPANY. Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: gyqot 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,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
WITH YOUR LENDER OMAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature rFL40�1111
2vessee/Con ractor as Agent for Owner Signature o4FL
r/License Holder
STATE O p� /�� STATE O RI
COUNTY OF �J(' vl� COUNTY OF (/YL L�—
The forgping ins r e t was acknowledged before me The forg ' g instrument was acknowledged before me
this day of 20_W by this ay of YV 20A-Dby
Robert Donovan
Name of person ma ing statement. Name of person making statement.
Personally Known�OR Produced Identification Personally Known �L OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-S e of Florida) (Signature of Notary ublicnri
-
/' ►u CH ST YN SALMONSON A 't"•"" ;.; CHRIS •LYN SALMONSON
Commission No.(�t7R ti ° �" Commission No. /3�� ': • - �j
*; c MY SSION#GG 930883 m� M1f ISSION#GG 930883
's+• �o`r EXPIRES:March 10,2024 '�+rF.•. P: EXPIRES:March 10,2024
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION, SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19