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All APPLICABLE INFO MUST BE'COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'a- _;LA Permit Number:
��o bMGDG� RECEIVED
Building Permit Application MAR 2 5 2021
Planning and Development Services
.5T Lucie County, Permitting;
Building and Code Regulation Division Commercial yes Reside
2300 Virginia Avenue,fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
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PROPOSED IMPROVEMENT LOCATION:
Address: 2987 Bent Pine Dr Fort Pierce, FL 34951
Property Tax ID#: 1327-701-0043-000-2 Lot No.073-thur85
Site Plan Name: Whippoorwill Run Townhouses Block No.
Project Name: Whipporwill Run Townhouses
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DETAILED DESCRIPTION OF WORK:
Remove wood roof shingles and install a 24 gauge 1"nail strip metal roof panels over a peel and stick underlayment j
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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 S r Z Pitch
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Total Sq. Ft of Construction: 9,800 Sq. Ft. of First Floor:
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Cost of Construction:$ 85,234 Utilities: —Sewer —Septic Building Height: 15' i
OWNER/LESSEE: CONTRACTOR: ! .
Name Whippoorwill run townhouses association, inc. Name:William Lasky
Address:3001 Johnston Road Company:Atlantic Roofing 2 of Vero Beach,inc.
City: Fort Pierce;Florida State:_ Address:4310 45th st
Zip Code: 34951 Fax: City: Vero Beach' State: i
Phone No.772-461-1218 Zip Code: 32960 Fax: 772-257-5740
E-Mail:gregsime@aol.com Phone N0772-492-8493
Fill in fee simple Title Holder on next page(if different E-Mailwljatr@aol.com
from the Owner listed above) State or County License CCC1326188
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 ok more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION 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:
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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. I
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 btain financing, consult
with lender or an attorney before commencing work or recording our Npae of arnmencement.
Signature&F O er/Lessee/Colitractor as Agent for Owner &Ign&&6 of Contractor/Li s Holder
STATE OF FLORIDA-- STATE OF FLORIDA
COUNTY OF _ L_Y7i� COUNTY OF
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Sw_orn to(or affirmed)and subscribed before me of Swofn to(or affirmed)and subscribed before me of j
V P�hy sical Presence or Online Notarization Ph sical Presence or Online Notarization
this L' ! day of YY1 L. ,202(/ by this day of Y7704- ,202(f by
Name of per&making statement. Name of person making s atement.
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Personally Known OR Produced Identification G_ Personally Known OR Produced Identification
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Type of Identificat, Type of Identification
Produced �'--{� oduced
LaOt P? i
(S)gadure 99'Notbry Public-State FI i ds`.)Commission#GG 1 L(Sig_n--a-fu e of Notary Public-S`"e'�f F or6561 , DE ORAHL.AUSTIN;
Expires January 6,2022 `•G�r F #GG 165615
Commission No. n . �FFjSeab ndedThruTroyFainlnsuranUpn No. I r S@�A}s
Expires January 6,2022
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20
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