HomeMy WebLinkAboutReroof Application- 7202 Santa ClaraAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: 9-29-2020
Permit Number:
S `l, LU LL
1 L C,' V, L �` ������� Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: RE ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: % 2 O Z �GG VI GrCccI��• ��U((d��
Property Tax ID #: i �� �' � - bOS8 - QQCD �
Site Plan Name:
Project Name:
I DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. -3
Block No. I b
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank —Gas Piping i Shutters _ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers _ Generator VlRoof Pitch
Total Sq. Ft of Construction: ' jS 2 Sq. Ft. of First Floor:
Cost of Construction: $ , cja� , UO Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
Name:
Company:
nn''
Address:- 12- 02- -i QA U
City: State:PL
Zip Code1 c5 Fax:
Phone Nd� ;! '- r ` 4 ��_-� �`
Address: /�q� J
City: C.State: �L
1'C�c:"t
Zip Code: �9 g� Fax:
Phone N �1"� L 2
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail CCfl
State or County LicenseOCC
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 CONSTRUCTI N 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: ZNot Applicable
BONDING COMPANY: ZNot Applicable
7
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. 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-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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ Lessee/C6rrtractor as Agent for Owner
Signature of Contractor/License older
STATE OF FLORID
STATE OF FLORID
COUNTY OF
COUNTY OF L
Swor o (or affirmed) and subscribed before me of
Swor o (or affirmed) and subscribed before me of
sical Pre nce or Online Notarization
`ical Presence or, Online N
thi ay of
thi 'day of 20 b °;
_f��/�\ UJ
0 00 m
_EWName
of person making statemen .
^Name
of person making s atement.oNo�c�Personally
1�7,
Known OR Produc
r iin
Personally Known OR ProducedI `*i�a
Type of Identification
- .°
Type of Identification <t a ." o 2
Produced
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Produced m m EEo02m;
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Ow
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nn z
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(Signature of N to Public- State of FLE
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(Signature of N t ry Public- State of Flori a�0
Commission No. 1�
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)
�.1
Commission No.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20