HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ?AVP N V1 Permit Number:
tjV 'D FEB 162017
Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Roof Ar
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Address: 789 SE Hidden River D.
Legal Description: HIDDEN RIVER ESTATES BLK 1 LOT 23(OR 3524-1592)
Property Tax ID#: 3427-701-0024-000-6 Lot No.
Site Plan Name: Block No.
Project Name: 789 SE Hidden River Garage and Playhouse Roofs
Setbacks) Front Back: Right Side: Left Side:
Remove and replace roofs on garage Main house roof replacement on separate
permit.
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Additionalwork toe e orme un ert ispermit—checka appy:
[1HVAC E]Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator _Roof 612 Roof pitch
Total Sq.Ft of Construction:_ `SD o S . Ft.of First Floor:
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Cost of Construction:$ '[ Utilities: _Sewer�Septic Building Height: 12
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Name Jeff Janocsko Name: Michael Walsh
Address:789 SE Hidden River Dr. Company: Michael Kevin Walsh Roofing, Inc.
City: Port St. Lucie State:FL Address: 3520 SW Armellini Ave#C1
Zip Code: 34983 Fax: City: Palm CityState:FL
Phone No. Zip Code: 34990 Fax: (772)781-0901
E-Mail: Phone No. (772)781-0900
Fill in fee simple Title Holder on next page(if different E-Mail: Waishroofing@bellsouth.net
from the Owner listed above) State or County License: CCC1330084
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER:.
� �a�J�"�y, „L d ,..:��. s.�Sta.S.. .m-...wx .=Not'Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: Stater 'City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes do 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.
Inconsideration 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
commencinR work or recording our Notice of Commencement.
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S' nwn ssee/Contractor as Agent for Owner ignat of Contractor License Holder
STATE O LORI A STATE OF FLORIDA
COUNTY OF COUNTY OF )�A.os�jj\
The forgoing instrument was acknowledged before me The forg,�gQ,in�g instrume t was acknowledged before me
thisLVd ay of 20 Eby this��day of a 20 by
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(Name of person acknowledging) (Name of person acknowledging)
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(Signatu ry P blic-State of Florida) (Signa e o tary P blic-State of Florida)
PersonallyKnown OR Produced Identification OR Produced Identification
Type of I en i roduced ype of Identi icati n Produced
�•„ EW JOHN SpfFF1071
Commission No. "+;'••• (�@ I ommission No. ":P'••4, MA"fflfiyOHNSAFFI07I
MY COMMISSION#GG 039979 ¢. MY COMMISSION#GG 039979
r:XPIRES:October 22.2020 = •;o EXPIRES:October=2020
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11— 'IndAwlitOMI
Revised 07/15/2014
REVIEWS FRONT . ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 88
COMPLETEOILLI-
INITIALS