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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
01�14r. LIKE
Building pp Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Roofing
PROPOSED IMPROVEMENT LOCATION:
Address: 141 NE Penlynn AVEPort St Lucie, FL 34983-1722
Property Tax IC #: 3419-570-0115-000-6 Lot No. 17
Site Plan Name: Conte Block No. 81
Project Name: (Conte
DETAILED DESCRIPTION OF WORK:
Remove exting roof cover
Renail deck to meet code/install new peel &Stick underlayment
Install new shingle roof/Tamko
New Electrical `\Aeter 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 I Pitch
Total Sq. Ft of Construction: 1615 Sq. Ft. of First Floor: 1615
Cost of Construction: $ 8,300 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameLawrence G Conte Name: Mauricio Orellana
Address:141 NE Penlynn AVE Company: One Construction & Roofing
City: Port st Lucie State:_ Address:2139 sw Coanant Avenue
Zip Code: 34953 Fax: n/a City: Port Saint Lucie State: FI
Phone No.772-763-0037 Zip Code: 34953 Fax:
E-Mail: n/a Phone No 772-240-9497
Fill in fee simple Title Holder on next page(if different E-Mail oneconstructionservices@yahoo.com
from the Owner listed above) State or County License CCC-1515745
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:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE C ANY: _ Not Applicable
Name: Name:
Address: A d d r
City: State: C. State:
Zip: Phone ip: Phone•
FEE SIMPLE TITL LDER: _Not Applicable BONDING COM NY: Not Applicable
Name: Name:
Address: Addres
City--, �i
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/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF S \ , —�•C.��_=
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
*---Physical Presence or Online Notarization - rhysical Presence or Online Notarization
this� y of 202a by this may of 202Q by
Name of person making statement. Name of person making statement.
Personally Known '__�OR Produced Identification Personally Known t' OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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of FloridaER ;.,,Y p�e4 PAULETTE BLAIR- of FlorLEX d
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Notary Public State of r l Public state
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(Signature of—Rotary Public- f :for u mm.Expires Sep 6,202a (Signature of Notary Pub►ic-Stat a Comma 6 2 2
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Commission No. Cs �s ( - Commission No. �'��
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/6/20