HomeMy WebLinkAbout102 NW Airoso Blvd Permit Flat RoofAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 08/27/2020
��Icic LLJC�LE
Chi? Ly
L L Q —^ r
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential xxxxxxxxxx
PERMIT APPLICATION FOR: REPLACE FLAT ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 102 NW AIROSO BLVD. PORT SAINT LUCIE, FLORIDA 34983
Property Tax ID #: 3419-555-0001-000/7
Site Plan Name: REBELLON'S RESIDENCE
Project Name: REPLACE FLAT ROOF
Lot No.1
Block No. 139
DETAILED DESCRIPTION OF WORK: I
REPLACING THE FLAT ROOF.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 1.000
_ Generator _ Roof
Sq. Ft. of First Floor: 7 SQ. FT.
Utilities. —Sewer _Septic Building Height:
FMT
OWNER/LESSEE:
CONTRACTOR:
Name NELLY PATRICIA REBELLON
Name:
Address:102 NW AIROSO BLVD.
Company:
City: PORT ST. LUCIE State: _
Zip Code: 34983 Fax:772-878-7457
Phone No.561-584-0635
Address:
City: State:
Zip Code: Fax:
Phone No
E-Mail: PATRICIAREBELLON@HOTMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC 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: _ 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commenciniz work or recording= vour Notice of Commencement.
'Lollu_�.
S'gg lure Owner/ Les Agent for Owner
Signature of Contractor/License Holder
of e/Contractor as
STATE OF FLORIDA
CL-C-ACOUNTY
STATE OF FLORIDA
COUNTY OF
OF
Sw rn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this J day of 1, f 12020 by
this day of 2020 by
y
Name of p rson making statement.
Name of person making statement.
Personally Known OR Produced Identification_
Personally Known OR Produced Identification
Type of Identification
�� 3 5 (>
Type of identification
Produced
Produced
(Signature of to I: Notary Public State
](Si4ppaare of Notary Public- State of Florida )
Uk; Commission k GG
Commission No. ( (Seal) My Comm. Expires Ap
7
ion No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20