HomeMy WebLinkAboutBuilding Permit Application AN-4PPLICAME M70 MUST BE £PLETED FOR APPLICA-1101LI TO RE SCCM
Date: 1211712020 Permit Number:
RECEIVED
Mr ��Qg � � JAM 19 2021
Permitting Department
EA
Building Permit Application St. Lucie County
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
iT i1aTlllt`0
Address: 9603 S Indian River Dr., Fort Pierce, Fl. 34982
Property Tax ID#: 351944400040004 Lot No.
Site Plan Name: Block No.
Project Name:
remove exisiting shingle roof, re-nail to code, dry in with eel-n-stick underla ment and
install Architectural shingles
remove exisiting torchdown, re-nail to code, dry in with peel-n-stick base sheet and cap sheet.
New Electrical Meter Second Electrical Meter
u .
CQ1 " CT,I€ N !Wbl g AY dN'
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 5/12 & Flat Pitch
Total Sq. Ft of Construction: 3354 Sq. Ft. of First Floor: 1533
Cost of Construction:$20,925.00 Utilities: —Sewer —Septic Building Height: 18
O" Rjl"ES EE: CC fiI C 0 I
Name Reynaldo Gonzalez Name: Richard Newland
Address: 9603 S Indian River Dr., Company: Richie the Roofer& Co. Inc.
City: Fort Pierce State: FI Address: 905 13th S SW
Zip Code: 34982 Fax: City: Vero Beach State:FII_
Phone No. Zip Code: 32962 Fax:
E-Mail: Phone No 772-473-6197
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License Cert#20506
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: F
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:
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 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.
R'5-YJYA)_Q0 GZD ZA1977.
Signature of Owner/Lessee/Contractor as Agent for Owner rgnature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLOW
COUNTY OF CT cvc16 COUNTY OF • k-LL p t'
The forgoing instrument was acknowledged before me The folgoing instrument was acknowledged before me
this S day of JAM RR ,207.( by this,-) day of I e .20LI by
REYNALM sanrzAc L `L'0_h Cy >la-Ad
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known Produced Identification
Type of Identification Type of Identification
Produced Produced
AIA- M , YIAQ
(Signature of Notary Public 1gr of Florida-Notary Pu 3�„(S(gnature of Notary Public-State of Florida)
m ission #GO 2336 9 ! �pllo glare of Florida
_s .c nI /�,
Commission No. =� �mmission Expire C mission No.v& (�L�91�
n fi ll%�`� June 28, 2022 y Aman a P Send�rao 26
Qci 2 33611 1 MY commission GG 211266
E)tplres o412512022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
_ DATE
COMPLETED
Rev.8/2/17
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