HomeMy WebLinkAboutMeyer reroof application'M%f 016.4;
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
•
Building Permit Application
Planning and Development Services
Buildin and Code Regulation Division
9 /
2300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772) 462-1553 Fax: (772) 452-1578 Commercial Residential
Address
Legal Df
Property Tax ID i✓: 3 IAQL `E l —10Titi %'6040 — Lot No. �_
Site Plan Name: Block No. —2
Project Name: �7Dyr
Setbacks Front Back: Right Side: Left Side:
coNSTRycTtor4, tNFORRAATION.
Additionalwo o pe un er s permit -:check a a apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator Roof -SIM (Pitch
Total Sq. Ft of Construction:
Cost of Construction:$ 1O�'60
Sq. Ft. of First Floor: _
Utilities: _Sewer _Septic
1
Building Height: i D
OWNERILMEE:
CONTRACTOR:
Name L
Name:_N41�
Address: 670 —TC
City: f.P� State: _
Zip Code: 3� Fax:
Phone No. 770—�" 77.E
Company�P
Address l v
City: v State:
Zip Code: 34QL Fax27Ji'3�S-"'1QX 1 �
Phone No7 — 6 Sb
E -Mail:
Fill In fee simple Title Holder on next page ( If different
from the Owner listed above)
E -Mail W • O$ A
State or C unt Licepsel/—� �GS�. r, 116
If value of construction is 2500 or more, a RECORDED Notice of Commencement is regwren.
SUPPLEMENTAL CONSTRUCTICYN LIENLAW INFORMATION:
DESIGNER/ENGINEER: "Not Applicable
Name:
Address:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
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 Countymakes 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 attorney before
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ignat of Owner/ Lessee ontractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAII�
W �`��
STATE OF FLORIDA
COUNTY OF 57 LU
COUNTY OF .S�
The for Ding instru enL as acknowledged before me
The f�B ging Inst was acknowledged before me
�? day /v 20& by
this day of 20O by
th of
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(Name of person acknowled n
me X perso acknowledge
of Notary Pr lic- tatv[off lorida)
(Signature o Notary P lac- Stat)# Florida)
/
OR Produced Identification
Personally Known OR Produced Identification v
P r onally Known -
Type of WentNication
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.
1022