HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPUCA110H TO IOE ACC-EPTED
1.18-2D27 Permit Number: —
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Building Permit Application
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frua n9 1WCr code fheguutron Diwp06 Commercial Re 5identi-ai
2,�ffl Vh-gaud Avenue, kytPk-rce f1349$.2
Phone: (772I 462-1553 F$a: [772)462-1S78
PER M IT APPLI CATI ON FOR, R E ROOF ~
PROPOSED IMPROVEMENT LOCATION; -
Address: 7 BAN DBURG.a LANE
Propertv Tax I a#: 3415-705.0104.000-6 Lot Nn. 103
Site PIa n.Narne: _ Binck No.
Project Name:
FDETAIL () DESCRIPTION OF WORK'
REMOVE SHINGLE ROOF
IN STALL P E EL& ST ICI{ FL2569
1NSTALL SHINGLE 1=1_183;45
New Electrical Meter_,Second Electrical Meter
CON$T:R LIOTIO N I NFO R MATI.ON'
Additional work to be petforrf ed under this Perm it—6wck all that apply!
Mechanica I _Las Tan k _Gas Pi ping _Shutters — Wi ndows/Doors _ftnd
Elt ctric _Pl:umbir►g 5prinklers _Generator Roof 5f112 Pitch
Total Sq_Ft of Construehon- 3,W Sq. Ft_of First Floor: 3 f
Cast of Construction; $ 17400 Utllltles' _Sewer _5ePG[ EWi Iding Height: 8 F F
OWNER/LESSEE: CONTRACTOR_
Name��kri0k wd0d� N ryy : ROLAND WILE=Y
Adclress:796 Sandburg LN Arno r y: S HORELI NE ROO FI NG
City: FORT$T LUC IE Stake; Afldress_1!�79 5W (�CENDALE 97FIEET
ZIP bode, 6 F�K: Citw: PORT ST LUCIE _5#ate-FI-
Phone No. Zip Code- 34987 _ - Fax:
E•Mail: _ _ Phone No 772-260-9565
rill in fee simple Tile Holder on next Page I if dit(ercnt E-Mai I SHORELI NEROOF I NGQPYAH00.COM
from the Owner listed uiraovel State or County License OCO 1331170
If Value 13,con,# 4; iorr is 2500 or more,a RECWDE F]Notre of Conirnenc eat Is requered.
1f value of HAVC is$$7,509 or mere,a RECORDED N;Alce&fomrm rncem&nt i3 ream-re .
SUPPLEMENTAL CONSTRUCTION LIEN LAUD INFORMATION:
DIESa63aNER/tWfl—R ER: _ Not Appkabte MORTGAGE C O M PANY: _ Not Ap pl ir-a ble
Name: Name:
"-dreSrx; _ Address
City_ #ate. City; State:
ZIP: PhorFa Grp: P:1(3-1e=
IrEE SIMPLE TITLE HOLDER- _ Nat Applicable BONDI..MG COMPANY: Not Appl icabl-9
NarnL-!_ N;)rn-e.
AddreSS: - ---- -- — - - Acdress. .. ----
CItY= City;
Zip: — _. — P hon e: _ ZI p- _ —Phone: _
OWNER/ CONTRACTOR AFFI DIMTr Application is hrre.byr made to abtain a permit to do thL•work aid imaull;ktion as ind imml d.
I tertrfy that.n0 work or Lnstal lation has commericed blot to the issuance of a permit.
w�l !e Oau makes no representation that ii granting a permit+,wdl authorize the permit holder to build the subject 5trumurc
iCh i5 ICI COn Iit With any applicaNe Home Ownef&Assotiarion rupes, bylaws of and aervenants that rfkay�re� stnct or prohibit such
s#rt•cture Please pO+KU$with your Nome Owners Associa4on Deed review your geed fat ayr n res#rictior%5 .ch-ay appiv.
I rr 4;4nsidcr#tiorr of the grRnting 4t thi5 rUgUest�ld permit,I cb hereby agruc thy#I will, in all rc'wci;ts�,perWm thr work
in accordance with the appeared plans,the Fkxlda eui Iding Codes and St.Luce CDuntyr Amendrfkmts.
The follumnig I+uading permit apoicgions are eNempt from uirio egoia$a fun concurtencyr(view:rooms adpilionk
KCei y$trUCkUre$. 5wifnMiMg pOOK f Wt&wOal!�.#igni,,Uretn roor1is and BCCe4X%r uses 10 tether use
VV A RN tNG TO OWNER,Yorar Ioiilkure to R*wp%d a iYake of Comnuna rrumt may rftuft in paying tw1c*for
rr,prove m erlts to)your property-A Notice of Corr menetment m ust be r-ecorded i a the publi a records of St-
Jucie County and posted on the jobsfte before the first irlspection. If Yov i mend t¢pl?tai n fi n anrirkE, cQnstrlt
Itlh I,e nder or an attomey before-comrnenci nitwofk of rocordlng your Notice of Commencement.
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15TATIE OF FLO f DA STATE OF FLAIR I BAS� �
COUNTY IDF sk. Luc - �T! COUNTY OF
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mq n t4p[pr aFFirmz�d]and subscribed hr ewe mewl $wgR LQ[-or affirmed)and fubscribed b--4rsrert5e of
_ PI-fysical Presence or-. Online Notarization :Phydcal Pre-A-rice or On line Notariza#iw
Ines_day of 20212 by this day of ,200 by
rybpx I _
N.amc of person rnaking s vm4k Name of person making atemeal.
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Personally Known OR PradUaed rdentificAic; PefiOn311yr Rwvwi oR Produced Identl0
Type of identifiicabon Twpe of ke ntl0eatlon
Produce E Produced A f!LT
�Sgnaku re aF Na@ft Publ-cState of Florida (Svnatum of riot ublic- State of Florida Ii
Commission NO i ka 1. Corrrmimior•Nu. (Seal)
i
REVIEW5 FRIJNT WNING 5UP RVi!SOR PLANS VEGETATION SEA TURTLE IVIANG4iCIVE
COVPJTI;H REVIEW FtEVtEw REVIEW REVIEW REVIEW 'REVIEW
DATE
RECEIVED
DATE
COMPLETED
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