HomeMy WebLinkAboutBuilidng Permit ApplicationAll APPUCAABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I 0 ! 'Z0"i Z :j Permit Number:
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- Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
I PERMIT APPLICATION FOR:Re-Roof
PROPOSED IMPROVEMENT LOCATION: 139 E Aldea CtPort St Lucie, FL 34952
Address: 139 E Aldea CtPort St Lucie, FL 34952 / RIVER PARK -UNIT 3- BLK 28 LOT 19(MAP 34/22S) (OR 1732-2772)
Property Tax ID #: 3419-515-0208-000-4 Lot MD.19
Site Plan Name: Block No. 28
Project Name: 606439 Greulich 139 E Aldea CtPort St Lucie
DETAILED DESCRIPTION OF WORK: T
Residential SFD/Duplex Shingle # of Sq. Ft. 2500
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 _5prinklers _ Generator Roof Pitch
Total 5q. Ft of Construction: 1900 Sq. Ft. of First Floor;
Cost of Construction: $ 19,100.00 Utilities: —Sewer _Septic Building Height:
OWN ER/LESS EE: Gerald E Grad&
CONTRACTOR: Donald BUchard
Name Gerald E Greulich
Name: Donald Buchard
' Address: 139 E Aldea Ct
Company:RoofClaim,com
City: Fort Pierce State: FL
Address:1690 Roberts Blvd. Ste 112 f
City: Kennesaw _State: GA
Zip Code: 34982 Fax:
Phone No.7722856224
Zip Code: 30144 Fax:
E-mail:terrygreulich@yahoo.com
Phone No407-278-7788
E-M,11Permit@RoofClairn.com
Fill in fee simple Title Holder on next page ( if different
State or County License CCC 1332081
from the Owner listed above)
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:
Name,
x Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
Address:
City:
Zip; Phone
State:_
City: State:_
Zip: Phone:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Applica5on is hereby made to obtain a permit to do the work and mstanavon as maicatea.
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 nlicable Home Owners Association rules, bylaws or ana 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 perk, 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 ppaying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on thejobsite before the first inspection. If you intend to obtain financing, consult
.6..g- .. nrlr n rurnrdina Vnor Nntice of Commencement.
WIVIIGIIVGI V o err
Signapdre of Owner/ Lessee/ ntractor as Agent for Owner
Sig Contractor/License Holder
STATE OF FLOLtIpq
STATE OF FLORIOA
COUNTYOF t3{ ILfL.0
COUNTY OF I`yf�
sworn to (or affirmed) and subscribed before me of
S orn to (or affirmed) and subscribed before me of
�Physical Pres nce orOnline Notarization
Physical Presence or Online Notarization
thisa' CI day of V6--QY 2020 by
t is�day of 6Ljbfidl_ -2020 by
Gpncfit Gctu�c�.c�.
�Nacc Y3ot,iLyii7na
i Name of person making statement.
Name of person making statement.
fPersonally Known OR Produced Identification)C
Personally Known _OR Produced Identification V
Type of lde icatlon
Type of Identification
�L
Produced W
ed
IF
CASEY R ELLIS
i
i State of Florida - Notary Pu
is
(Signature cif Notary Public- Stat Flor zs*n I
Expires Sep.0,
lure of Nota blic-State of Florida )
1��11 ���`AA My Commesion
Commission No. Ctn SQ'I I
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ission No. ' 3 (Seal)
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DATE
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DATE
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