HomeMy WebLinkAboutRUZICKA APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: - Z-5- .20 a / Permit Number:
O
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
PERMIT APPLICATION FOR: JOHN RUZICKA
PROPOSED IMPROVEMENT LOCATION:
Address: 6627 GAVIOTA
Property Tax I D #: 1306-500-0025-000-8
Site Plan Name:
Project Name: RUZIKA
DETAILED DESCRIPTION OF WORK:
Residential X
Lot No.10
Block No. 38
REROOF SHINGLE TO SHINGLE USING RESISTO FOR UNDERLAYMENT AND OWENS CORNING DURATION FOR SHINGLES
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 'X Roof 5112 Pitch
Total Sq. Ft of Construction: 3000
Sq. Ft. of First Floor: 3000
Cost of Construction: $ 11,000 Utilities: T Sewer — Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJOHN RUZICKA
Name: EDWARD LECHNER
Address: 6627 GAVIOTA
Com an EDIFICIUM CONST
p Y�
City: FORT PIERCE State:
Address:1215 CASTAWAY BLVD
_
Zip Code: 34951 Fax:
City: VERO BEACH FL
State:
Phone No.
Zip Code: 32963 Fax:
E-Mail:
Phone No 772-643-4513
Fill in fee simple Title Holder on next page ( if different
E-Mail edificiumroofing@gmail.com
from the Owner listed above)
State or County License CCC1 331308
If value of construction is 2500 or mnre a RFrnRnen ni„a:- -z,-
-- -- - ... %.� V1 . U111u1cuLt!1FJCrr[ is require}].
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
F
PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
SIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
me: Name:
dress: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE MOLDER: 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 ttorne before commencing work or recording our Notice of Commencement.
Signature of Own /Lessee/Contractor as Agent for Owner Signature of Con#ractLicense Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF INUAN RIVER COUNTY OF INDIAN RIVER
Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization X Physical Presence or Online Notarization
this 5 day of JAN 2021 by this 5 day of JAN 2020 by
EDWARD LECHNER EDWARD LECHNER
Name of person making statement. Name of person making statement.
Personally Known x OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Prod%ed If Produced
of Notary Public- State
/
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