HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JUNE 16 2020 Permit Number:
RECEIVED ---
JUN 2 � 2020
Building Permit Appli ation
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 TYPE: RE ROOF - SHINGLE
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PRbPOSED-IMPROVEMENT'L'OCATIO
Address: 3400 AVENUES
Property Tax ID#. 2405 601 0079 000 8 Lot No. 15
Site Plan Name: Block No. 4
Project Name:
DETAILED°DESCRIPTION OF WORK:
RE ROOF SHINGLE
J .', t�•,� n
CON5TRU,CTION,I NFORMATION
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_Electric _Plumbing _Sprinklers _Generator Roof 4/12 Pitch
Total Sq. Ft of Construction: lyrx-> Sq. Ft.of First Floor:_ //0�
Cost of Construction:$ 7Soo • Utilities: _Sewer _Septic Building Height:
(*NERf LESSEE CONTRACTOR
Name BEVERLY R RICHARDSON Name:TODD ADDERLY
Address:3400 AVENUE S Company:ADDERLY DEVELOPMENT INC
City: FT PIERCE 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 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION ,
pp MORTGAGE COMPANY: _Not Applicable
DESIGNER/ENGINEER: _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 thepermit 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 OR AN ATTORNEY BEFORE RECORDING TOUR NOTICE4 OF COMMENCEME T."
Si ature of wner/Less a/Contractor as Agent for Owner Signature of Contr ct r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF BRO-RD
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 16 day of JUNE 202020_ by this 16 day of JUNE 2020 20_ by
Name of person making statement. Name of person making statement.
V6
Personally Known OR Produced Identifi ation x�_ Personally Known xxx OR Produced Identific tion C_
Type of Identification z a Type of Identification m ,�
Produced FLID o vN Produced o o
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(Signat of Notary Public-State of Florida XC.m o o (Signature of Notary Public-State of Florida) w o m e
m �OD r �� -M
Commission No. O/
( f�! c o Commission No. (S a Co
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REVIEWS FRONT ZONIN SAE ISOR PLANS VEGETATION SEATURTL MA11GR VE
COUNTER REVIEW W REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
lev. 2/7/19