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ALL APPLICAB E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED1 '703
'X Date: J Permit Number: LJ 1
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 X
PERMIT APPLICATION FOR: Roof r YTA �-q
PROPOSED IMPROVEMENT LOCATION:
Address: 5911 Hickory Drive, Fort Pierce, FL 34982
Legal Description: INDIAN RIVER ESTATES-UNIT 08-BLK 69 LOT 22(MAP 34/11 S)(OR 1278-1527: 1602-2894)
Property Tax ID#: 3402-609-0628-000-0 Lot No. 22
Site Plan Name: Block No. 69
Project Name:
Setbacks Front Back: Right Side: Left Side:
FDETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be nerformed under this permit—check all apply:
[1HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers FI Generator W1 Roof 5 12 Roof pitch
Total Sq.Ft of Construction: 2,160 S Ft.of First Floor: 2,160
Cost of Construction:$ Utilities: Sewer Septic Building Height: 1 story
OWNERAESSEE: CONTRACTOR:
Name Greg Giametta and Donna J Zatyko Name: Richard V.Colletti
Address: 5911 Hickory Dr Company: Leak Busters Roof Repairs, LLC
City: Fort Pierce State: FL Address: 6101 Buchanan Drive
Zip Code: 34982 Fax: c� City: Fort Pierce State: FL
Phone No. n Zip Code: 34982 Fax: 772-264-0378
E-Mail: Phone No. 772-332-8450
Fill in fee simple Title Holder on next page(if different E-Mail: richiecolletti@gmail.com
from the Owner listed above) State or County License: CCC1330976
If value of construction is$2500 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 TITLE HOLDER: _Not Applicable BONDING COMPANY: 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 recording our Notice of Commencement.
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hn 0 JAIA A,�J J & (� � 0 �Ild AA J�(J_
gn re of wner Lessee Contractor as Agent for Owner na ur of ontractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF cc')0_;_ck 1 )C i 2 COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of P IgN. 20 Eby this_,;L day of M w r D ,20 QL by
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(Name of person acknowledging) (Name of person acknowledging)
,gn Rn telq
(Signat a of Notary P blic-State of Florida) (Signatifireof Nota Public-State of Florida)
Personally Known_-)( —OR Produced Identification Personally Known _OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. C C t - gmua, SALLY PORTES fission No. C L 5 (Seal)
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Commission#GG 476 5 s;.:�1�;.. SALLY PORTES
Jo 44
4,,,,,�„„�.. y ,P My Commission Expires
Revised 07/15/2014 r yNp��R��`' November 15, 2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW ' REVIEW
DATE
COMPLETE
INITIALS