HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO 'M UST Bt COMPLETED FOR AMPUCATI GN TO BE ACCE PTED
Date: 12-17- 020
Permit N u mbi� r'
Building Permit Application
Pr.7.nriMg arrd Deve,'QpMen t -'OrrvJLas
Er.ufWjrV and Co6e RegUfa tf0A DN,$kn Co rn m ercia l Re s ld-nt i a l
2300 Virginia Avenue, fort Prefce FL 3A982
Phpni!=1772M 462-155� Fax: (T72) 462-1578
1T A PP LIGATION FOR; R E ROOF
FARO POSj-6 IMP R45VEM ENT LOCATION;ACW _
ress: 373 EURC PEA N LAN E 1r F P1 EFIOE
PrapertY Tax 1p M- 3410- -021 0-6
$ite Plan Name:
Lat No.3
Black N&. H
Project #dame, - -
DETAILED DESCRIPTION OF WORK:
REMOVE SHINGLE ROOF
INSTALL PEEL & STICK UNDERLAYMENT FL16048
INSTALL SHINGLES FL10674
New E lectrica I Meter _ Secorrd eeCtriCal Melef
CQNSTRUCTION INFORMATION'.
Additiornal ~work t-0he performed under tti Is Rgrrnit —check all that apply-
_ mechanical —Gas Tan k _bias Pipirkg -Shutters , VY Indow�st rs _ Panel
v f lie tric _ PI umbl r1i _ sonk lees _ Generator , Roof 5112 Nub
ToUl Sq. Ft ofConstructior1: 2.172
Cost of Construetlon; $ , ' 0
OWNER/LESSEE:
Johanna Dull n
Acldrims;:373 European LN
iT,_ FT P I E RCE state;
Zip i_Ddw 34962 Fax:
Phone No_
! q, Ft, of Firrt Floor;
2,172
thillties- _Sewer _ Saptic
Roil -ding Height; $ FT
CONTRACTOR; T
Name: RO LAND WkLE Y
ComparYyr-SHORELINE ROOFING
Address; 1973 SVV GLENDALE STREET
city, PORT ST LUCIE Ste: FL
Zip Code: 7 fax: .
E-Mail- _ _ I phDrLe No �72-26 $ E S
Fill in # simple Title Holder on next page it d iff r� nt E flail SHORE L I N ERQOF I NG YAHOO.COM
from the owner listed above) State or Cou ntg bEense CCC 1331170
If value of constructiDn is 250 or more, a RECOPIED Nfftice of tom mencem m is required.
if valve of HAVC is $7,sm or m0FWr 0 RJECO DEa Noire of Commsn—Meet Is regUir4rd-
MORTGAGE COMPANY, _ N-at Applicable
fume;
Add ress_
City; _ State: �..—
Zip Phone;
WN DING COMPANY: —Nat Appl icabl e
I Name;
,address:
Zip: Phorl�:
OWN E Ft/ CONTRALTO R AF F I DVIT: App+llcation i5 helebY made tv obtal n a permit to do the work arld irWalla4-on as indicated.
I terti V that no work or install atinn has comrn&nced prior to the issuance 4of -a perm L
St, Lucle County m6ke5 no represent-Al*n that is granting. a perm it will authorize the errn ft holder to twild the subject 51ructure
which is in corfM itt with any applicable Hume; Owners Assoc4tLprk rules, bylaws of and ccryenants #hat mar reskrlc# 4ar prohibit such
5trurture. Please consult Wth your Home OYwnefs Association ;;rLd rewiew your died for arw m-jtrictl4ans which may+ apply.
in consideratiDn of the granting of this requested perrnil, I do hereby ag{ee that I will, In pI I respvt15, pew the work
in mc*rdan a with the approved plans, the Florida Bu 1&i g Codes and St. Lucie County mdments_
The Following bu'il(ling permit apC41cMkprts are ext!m pt from underpl no a full canevrrency review; roCm additions,
mcu ssorV structuires, swirriming pools, ferwesr wall s, sgn!�, screen room }grid accessory uses to another mon-residential use
WARNING TO OWNER, YOU r faklu re #o FRe[Qrd a Notice of CommeTxement may rtw It in paying twice for
i rn proveme rats to y-ou r p rD pertyd, A Nuti ea of Com m r�ncemera must be recorded I ri th a publ it records of St.
Lu cie Lou My an d posted -on the jobs it a before th a fi r5t i ns-pect ion, If Yo u; i Wend t-0 obtain fin a nr i rwg, consu It
with lender or an attvrrkey before rvmme acing irk in r record i nw-otl r f+Motice vf� ncem �rtit.
Si6m.atu re of Owner e!;4WCv ractoi o s Agent for Owner 5igrwrture of Contra {G dense H r
STATE OF FL091DA
co U NTY OF - L kA
i to Or affirmed] i)nii su!bscfibed before me of
phy+sica I Pre;amL- or Online NotarixatilOR
day of 2070 by
�1 n(� I1)I'lin I
S U P PLEMENTAL CC) NSTR U CT 10 N LIEN LAW I NFORMATION,
DESIGN ERf ENGsi DEER: _ J4,at Appl is able
Name-__
Address;
cdtf, State'
Zip; _ phone
FEE SIMPLE Tr%E HOLD E R: _ Not Applicable
Flame:
Address'
C ityf:
ZiP: Plhrone;
STATE OF FLORID
COUNTY OF 1IC t J
5wo r t* Jor affirmed f anti subscribed before me of
_ Priyslcal Presence or Online Nos-brizatyon
thi day of 20204
LIU
NO
Name fl# pegs r1 m $king k- ! blame of person making s em-e t.
r
�`
"rspaadly Known _ OR Praduocd IdentlfYr.�L9 i P�� spnallyr KnQ�vn OR fYoduced I d4 ndflcatJ
Twe of Identification Type of Identification 5
Pr u d o 9i ProduKed —
m
I5Gnature of Public- stag pf Flonda ) [Signature of No ' Puhlio- 50te & Florida ]
i' d
m mission N [Seal)
Commi SSian Np.
�.} . #+
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