HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i
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Date: 1 a, a 1 Permit Number: a,�1� I6
RECEIVED
• J�N 2 2 2011
FEW- ; .D, a = _ ` i Department j
Building Permit Application Pefmitting
5t,Lucie County
Planning and Development Services
Building and Code Regulation Division Commercial ReSI ential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR: 5V METAL RE-ROOF
PROP_OSED.IMPROUENi:ENT LOCATION
Address:4915 MYRTLE DR FORT PIERCE, FL 34982
3402-608-0144-000-0 f 28
Property Tax ID# i Lot No.: I
Site Plan Name: INDIAN RIVER ESTATES-•UNIT 7 Block No.i 42
Project Name: 5V METAL RE-ROOF
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DETAILED DESCRIPTIONOF WORK:, j f
RE-ROOF FROM SHINGLES TO 5V METAL CRIMP.
New Electrical Meter Second Electrical Meter
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CONSTRUCTION i;NFORMATION
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Additional work to be performed under this permit=check all that apply: i
—Mechanical —Gas Tank —Gas Piping I—Shutters —Wino %Doors _P nd
Electric —Plumbing —Sprinklers Generator Roof` 4/12 Pitch:
Total Sq. Ft of Construction: 6 '1-aq stG ram' Sq. Ft. of First.Floor:
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Cost of Construction:$ 13,000.00 Utilities. —Sewer —Septic ; Building Height: ' }
OWNER/LES,SEE .; CONTRACTOR: 4 }n r ! F
Name/ i S IZ ciCl 2 Name: /-//'0 U IE 41,°Z7-
Address: DIf. Company: 12r
City: P -_54- . LCl r r Q State: �r'- Address•,0 71"� Sts L'rm'I Ca
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Zip Code: .3 �.� Fax: City: 2 vy" ? ° State_ : �
Phone No. `�- - yC1. y3/ Zip Code:S KIT Z Fax:
Y --®(Al 9' � ��f'►'I�i U Z ;
E-Mail: ch'1 v�j� ,.�U�yj Phone No Z � ZZ4�0 r�'�/2`.S�
Fill in fee simple Title Holder on next page(if different E-Mail ,/tr.' n f ' i1do aAzo4.11 OA4
from the Owner listed above) State or County License I ` a Cl j
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 okommehcement is required., If
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SU;PPLEMENTALCONSTRUCTION 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:
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.
Signature of Owner/Less-ee/Corifractor as Agent for Owner Sig ure66f ntractor/License der
STATE OF FLORIDA Q - STATE OF FLORIDA
COUNTY OF ut -ZVO le COUNTY OF S V
S to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Ph sical Pres ce or Online Notarization Physical Presnce or Online N tarization
t is day of 202p by this day of �'� ,202Z by
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ame of person making stat ent. Name of person making statement.
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4entaown OR Produced Identification Personally Known OR Produced Identification
fication Type of Identification
Produced �l. OL-No Publi -State of Florida) (Signature of Notary Public-State of FloridaCommissionN Z (Seahayna M.Brooks Commission No. (Seal)
�ot�Y�ss NOTARY PUBLIC
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REVIEWS FRONT C§U PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVYIIIP xp4�� REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.5/6/20