HomeMy WebLinkAboutBuilding permit application I
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q�
Date: Permit Number: (/
Building Permit Application �Q �0�0
Planning and Development Services 10/0 a
Building and Code Regulation Division ey9�eht
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential XX
PERMITTYPE: ROOF SHINGLE
PROPC►SED,I,NIPROVEMENT LOCATION
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Address: 3908 Avenue M
Property Tax ID#. 2405-60170461-000-3 Lot No.15
Site Plan Name: Block No. 25
Project Name: Duane Alexander Sharon Alexander
DETAILED DESCRIPTION OF WORK r
RE ROOF SHINGLE {C� �1/1t l� G� a S,441
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CONSTRUCTION INFORMATION
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Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/ oors
_Electric Plumbing _Sprinklers _Generator Roof Pitch
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Total Sq. Ft of Construction). I vf & Sq.Ft. f First Floor:
Cost of Construction:$ _ SCJ Utilities: ewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR
Name Duane Alexander Sharon Alexander Name: TODD ADDERLY
Address:3908 Avenue M Company:ADDERLY DEVELOPMENT INC
City: Fort Pierce, FL State:_ Address:5079 N DIXIE HWY#258
Zip Code: 34947 Fax: City: OAKLAND PK State:FL
Phone No. Zip Code: 33334 Fax:
E-Mail: Phone No 954 445 4078
Fill in fee simple Title Holder on next page(if different E-Mail adderlydev@yahoo.com
from the Owner listed above) State or County License CCC 1327886
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 orrmore,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CON5TRUCTION LIEN LAW INIF
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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,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 OjR AN ATTORNEY BEFORE RECORDING OUR NOTICE OF OMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor i ense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF bard COUNTY OF&—rd
The forgoing instrument was!acknowledged before me The forgoing instrument was acknowledged before me
this » day of MARCH 20_ by this » day of MARCH 20_ by
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Name of person making statement. Name of person making statement.
Personally Known OR Produced Identificatio Personally Known OR Produced Identification
Type of Identification Type of Identification
Pro du d Produced
(Sigrfature of Notary P - (Signature of Notary i - a e o=FmN
WG0WMM#FFVW1
Commission No. W___S#tAKtE1- 5341 Commission No.
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Bonded t Cough tst Stete t Bonded tMa tat st e t
SOMMON
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.