HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED )
Date: ( � Permit Number: 17 d—
91r.l�l�l RECEIVED
O JAN 0 5 2020
Building Permit Application 4�ttnlltingDepartment
Planning and Development Services
St. Lucie County
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: Roof Repair of screen enclosure
PROPOSED IMPROVEMENT-LOCATION:
Address: 3808 Sloan Rd
Property Tax ID#: 2405-704-0013-0004 Lot No. 13& 14
Site Plan Name: Sumner Hgts Block No. A
Project Name:
DETAILED DESCRIPTION OF WORK:
Roof repair of Screen room — LQ I q oC R,tl Q 4)Q{ V-3
A�}N E1S
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 flat Pitch
Total Sq. Ft of Construction: 16 x 21'9" Sq. Ft.of First'Floor: 16 x 21'9"
Cost of Construction:$ 'a— L'-00' Utilities: —Sewer _Septic Building Height: 84"
OWNER/LESSEE: _ CONTRACTOR:
Name Michael and Zadie Rosson Name: Owner/Builder
Address: 3808 Sloan Rd Company:
City: Fort Pierce State:_ Address:
Zip Code: 34947 Fax: City: State:
Phone No.772-465-1259 Zip Code: Fax:
E-Mail: mszr@bellsouth.net Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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: xx Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:Chase Home Lending
Address: Address: Mail Code LA"911.700 Kansas Ln
City: State: City: Monroe State: LLA
Zip: Phone Zip: 712os-ana Phone:a77-5os2a94
FEE SIMPLE TITLE HOLDER: >d 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 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 attorney 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 FLORIDA STATE OF FLORIDA
COUNTY OF stud- COUNTY OF
Sw to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this 5 day of 202lf by this day of ,2020 by
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Name of person making statement. / Name of person making statement.
Personally Known OR Produced Identification✓ Personally Known OR Produced Identification
Type of Ide tification Type of Identification
Produced FlbrA& 'C o/ L— Produced
AA�6"6_
(Signature of Notary Public-State of on ae .. ure of Notary Public-State of Florida)
sy��;.: j�'••.. SUSAN A.BOW•N
6�3 Notary Public-State f
Commission No. ,s��a Commission-GG 3 8� sion No. (Seal)
My Comm.Expires Jul 28,2023
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