HomeMy WebLinkAboutfalla permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09-24-2020 Permit Number:
91T.1yh1�1i `
0
' Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce Ft 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Flat Reroof
PROPOSED IMPROVEMENT LOCATION:
Address: 8503 S Indian River Drive
Property Tax ILS fi. 3518-433-0003-000-0
Site Plan Name
Project Name:
Lot No.
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
Electric _ Plumbing „Sprinklers
Total Sq. Ft of Construction: Z `J
Cost of Construction: $ 3800.00 Utilitie
Name ut--f a J
Address: '?t50'S lo %Aon 3MG, fa i( r-WQ
City: V:3g `—J?lr�G£ Stater
Zip Code: 97— Fax:
Phone No. =k^ 1? 1 r � yr "1184i 04
E -Mail: %,<'-Q(. I.A, C0-GiCa1_, C -4M
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
_ Shutters _ Windows/Doors _ Pond
_ Generator Roof 2/12 Pitch
Sq. Ft. of First Floor: 2(A
s: _Sewer _Septic Building Height:
CONTRACTOR:
-Name: Richard Colletti
Company: Leakbusters Roof Repair
Address: 6101 Buchanan Drive
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No 7723328450
E -Mail richiecolletti@gmail.com
State or County Licenser-
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 LAIN INFORMATION:
DESIGNERJENGINEER: 4-1 Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address: _
City: State:
Zip: Phone:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
Address:
_
City:
Zip: Phone
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the worK and instanatron as murcased.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. LucieCounty 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-residentiai 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-att-al+ ney before commencing work or retarding your Notice of Commencement.
as Agent for Owner
ST'*TE`OF FLORIDA j
COUNTY OF kU- Ic
Swo to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
'CL's, P, .' r—a–.(
Name of person making statement. %
Personally Known �£ OR Produced Identification
Type of Identification
Produced
(S�grfat f Notary Public- StaT�m�' iorida) KATHERINE HAVENS
MY GOMMISSION #GG o
Commission No.'aI)EXPIRES: DEC 04, 202
Bonded through 1st State Ins
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
TE
CO
---= A f
Signature df Contractor icense Ho er
STATE OF FLORIDA
COUNTY OF
5Von to (or affirmed) and subscribed before me of
hysical Presence or Online Notarization
this day of 2020 by
t
Name of person making statement.
Personally Known �k OR Produced Identification
Type of Identification
Produced
ure-W-Notary Public- Stat �j�f qil a ) KATHERINE HAVENS
_ MY COMMISSION #GG165
ssion No. .9� 1 $e IRES: DEC 04, 2021
Fes, Bonded through 1st State Insur
PLANS REVIEW REVIEW REVIEW REVIEW
VEGETATION
S LE MANGROVE
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