HomeMy WebLinkAboutBuilding Permit Application {
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater a'`� 1 Permit Number:
R.ECEJVU FES 0 0-2917
Building Permit Application
Planning and Development services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential xXXXXXxx
PERMIT APPLICATION FOR: Roof,
P.RO.POSED IMPROVEMENT LOCATION
Address: 8580 MARY ANN LN. PORT ST. LUCIE, FL 34952
Legal Description: LA BUONA VITA COOPERATIVE,UNIT/LOT 110(OR 3619-502)
Property Tax ID#: 3426-664-0108-000-4 Lot No.110
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
•DETAILED DESCRIPTION 00,WORK
REMOVE EXISTING ROOF
REPLACE ROT 1 y v
INSTALL ASTM-226 30# LINDERLAYMENT
INSTALL 26 GA METAL ROOF SYSTEM C�[
CONSTRUCTION N' FORMATIQiV "
Additionalwork to be nertormed under this permit—check all apply:
E1HVAC Gas Tank ❑Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers 1-1 Generator Z Roof
Total Sq. Ft of Construction: 1,600 S . Ft.of First Floor:
Cost of Construction:$ 6,800 Utilities: Sewer FSeptic Building Height:
OINNERAMEE: : CONTRACTOR:°
Name BETTY SHEARS Name: JOE BAKER
Address:34 pEfW• R 106,E • Company: BIG LAKE ROOFING:&REPAIRS
City: VESTAL State:NY Address: 2699 NW 16TH BLVD.
Zip Code: 13850 Fax: City: OKEECHOBEE State:FL
Phone No.607-754-0287 Zip Code: 34972 Fax: 863463-7662
E-Mail: Phone No. .863-763-7663
.Fill in fee simple Title Holder on next page(if different E-Mail: BIGLAKEROOFING@YAHOO.COM
from the Owner listed above) State or County License: CCC046939
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S.UPPLEIUIENTALCONSTRUCTION LIEN LAW iNFORl1%IATION`;
: .
DESIGNER/ENGINEER: xxx Not Applicable MORTGAGE COMPANY: xxx Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: xxx Not Applicable BONDING COMPANY: xxx Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 your paying twice for
improvements to your property.A Notice of Commencement must be recorded 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/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA I 1_ _ STATE OF FLORIDA
COUNTY OF 0 -PLI�•o YX'-f COUNTY OF'
The fo Qing instr ent was acknowledg a k-fore me The forgoing instr ent was acknowledg,1 efore me
this�'day of 20�by this`�'� day of 20_ by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Produced Identificati n
Type of Identification Procgjr,��j Type of Identification P 'lMee�l
`I PpY P I .�
�y
Commission No.- ___ COM )ON#FF125216 Commission No. e� ` = COMMIS 21,2018
Q= EXPIRES: May 21, 2018 oQ EXPIRES. ay 21, 2018
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Revised 07/15/2014 -
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