HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 11-18-2020 Permit Number:
`L Ll cuL_
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r � Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential xxx
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: RE-ROOF
PROPOSED IMPROVEMENT LOCATION:
Address: 8248 Sand Pine Cir. Port St Lucie, FL 34952
Property Tax ID#: 3426-703-0029-000-4 Lot No.15
Site Plan Name: Lake Lucie Estates Plat. Block No.
Project Name: Jim Laning
DETAILED DESCRIPTION OF WORK:
tear off existing roof, nail deck to code, apply new underlayment per code and install new standing seam metal roof
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: tQ1(cq Sq. Ft.of First Floor:
Cost of Construction: $ 21775.01 Utilities: —Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name larnepS L.n Name:
Address�: RGIb nl•) r [ 'AtClG Companyyallrnn�P
City:IN �- I t[ t 4ej State:EL_ Address:I OICT ghl 16Fn t-�P_
Zip Code: 3`Iq5 orl Fax: City: YM� S-�r L1n i'f _State:'EL
PhoneNo. -77cg Iaol0 40LA17 Zip Code: 3yg7lp Fax:
E-Mail: Phone No 770R -L-Ha-g001
Fill in fee simple Title Holder on next page(if different E-Mail 0LdaM f C C an - IG
from the Owner listed above) State or County License ACC 03'M 12
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: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
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 Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co 1xict 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 attorney before commencin work or recording your Notice of Commencement.
1:) 1 1:o:2
Signatu caner/Lessee/Contractor as Agent for Owner Signature o ontractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF `b-. ucm?r COUNTY OF ": +-
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
✓Physical Presence or Online Notarization V Physical Presence or Online Notarization
this J1 day of McdtmMe r 2020 by this IT—day of I c:,Jer �_2020 by
Mn,o_)IP_ O 10�n Yn n _ 1i� yiw�1e &OVYTY3 n
Name of person making statement. Name of person making staterhent.
Personally Known ✓ OR Produced Identification Personally Known f OR Produced Identification
Type of Identification Type of Identification
Produced d Produced
- `�""'"_ dam•'
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
FRANK LASASSO FRANK LASASSO
Commission No. OTARYSKW1C Commission No. TARYONflC
L STATE OF FLORIDA3 STATE OF FLORIDA
€t'0 REVIEWS FRO 1RN-0 SUPERVISOR PLANS VEGETATI• SEXM@R1L� RMNGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.
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