HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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
PERMIT APPLICATION FOR: Roofing
PROPOSED IMPROVEMENT LOCATION:
Address: 2_3J L1 Al �/ ' `�y"� i f"i CC-
Property Tax ID#: 1431 -701-0160-000-8 Lot No. 12-13
Site Plan Name: Thompson Block No. J
Project Name: Thompson
DETAILED DESCRIPTION OF WORK:
Remove and replace existing roof cover
Install New peel &Stick underlayment
Install new shingle/Tamko
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 _Sprinklers _Generator —Roof 5/12 Pitch
Total Sq. Ft of Construction: 2326 Sq. Ft. of First Floor: 2326
Cost of Construction: $ 15,000 Utilities: —Sewer —Septic Building Height: 8.
OWNER/LESSEE: CONTRACTOR:
Name Brenda Thompson Name: Mauricio orellana
Address: 2314 N 49th st Company:One construction & Roofing
City: Fort Pierce FI State:_ Address: 2766 sw Edgarce st
Zip Code: 34946 Fax: N/A City: Port Saint Lucie State: FI
Phone No.772-453-0087 Zip Code: 34953 Fax: N/A
E-Mail: N/A Phone No 772-240-9497
Fill in fee simple Title Holder on next page(if different E-Mail oneconstructionservices@yahoo.com
from the Owner listed above) State or County License CCC- 1330623
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 CONSTRU 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 HOLDS . _Not Applicable BONDING COMPANY: Not pplicable
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. 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 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 attorgow before commencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORID STATE OF FLORIDA
COUNTY OF '\ - COUNTY OF
Sworp,to(or affirmed)and subscribed before me of Sworn (or affirmed)and subscribed before me of
✓P Presence or Online Notarization Physical Presence or Online Notarization
this ay of ��• t�(( 2020 by this day ofv 0 by
Name of person making statement. Name of person making statement. —�
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-State of I In..
Signa ure of Notary Public-Sta ErrEBLAIR•ALEXANDER
PAGLETrE ALAIR•ALEXANK Notary Public•state of Florida
�3 F ')Nosy Public•State of Flori / �( �.<i �si #GG 987031
Commission No. tG3� a 8i
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ionded throu;h National Notary As Bonded thfa*National Notary Assn.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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