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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. .
r '
Date: `eA �1 RECEI! r FEB Permit Number:
.;D 09�2017
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
PROPOSED IMPROVEMENT LOCATION:
Address: 8590 MARY ANN LN. PORT ST. LUCIE, FL 34952
Legal Description: LA BUONA VITA COOPERATIVE UNIT/LOT 108(OR 1398-1724)
PropertyTax ID#: 3426-664-0106-000-0 Lot No.108
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION QF'WORK:
REMOVE EXISTING ROOF
REPLACE ROT I V 1 D b(
INSTALL ASTM-226 30# UNDERLAYMENT 1 a
INSTALL 26 GA METAL ROOF SYSTEM
1CONSTRUCTION' INFORMATIOW ,
Additional workto e e orme under this permit—check a apply:
�HVAC 13 Gas Tank ❑Gas Piping 1-1_Shutters Windows/Doors
0 Electric F-1 Plumbing Sprinklers E]Generator Z Roof
Total Sq. Ft of.Construction: 1,600 Sq. Ft.of First Floor:
Cost of Construction:$ 7,500 Utilities: Sewer Septic Building Height:
OW NE'RAESSEE. CONTRACTOR:
Name ROSEMARY BRONZING Name: JOE BAKER
Address:8590 MARY ANN LN. Company: BIG LAKE ROOFING&REPAIRS
City: PORT ST. LUCIE State:FL Address: 2699 NW 16TH BLVD.
Zip Code: 34952 Fax: City: OKEECHOBEE State:FL
Phone No.631-928-9251 Zip Code: 34972 Fax: 863-763-7662
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.
SUPPLEMENTAL CONSTRUCTION LIEN JLAW INFORMATION'
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 rec ding your Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORI A
COUNTY OF � 1 Ly��.� COUNTY OF 64
The forgoing instrument was acknowledged before me The forgoing instr rrent was acknowledg d before me
this T day of 20('1.by this�hday of 20 1 by
(Name of person acknowledging) (Name of person acknowledging)
\� l
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State o Florida)
Personally Known `0 ,fpduc i 'Q�"ate Personally Known-'' / \ OR Prod ed de
Type of Identification Pro l�a�% tlYu�uJ�" Type of Identification P� �1P�� t�YY �
4 a "= COMMISSION#FF125216 $Q'. COMMISSION#FF"�5216
Commission No. =�`. EXP $: May 21, 2018 Commission No. _4� EXPIRO.eft 21, 2018
e %Q:��� WWW.RARONNOTARY.COM %` i...... wwyy.p,ARONNOTARY.COIA
Revised 07/15/2014
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