HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ 1
Date: Permit Number:
I�os Q/S-7
Building Permit Application MAYo
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Plbnning and Development Services PEFI&JIT.T.IN
Building and Code Regulation Division 5t.Lucie Co C
2300 Virginia Avenue,Fort Pierce FL 34982 ut FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial . Residential X
PERMIT APPLICATION FOR: Roof -
,PROPOSED IMPROVEMENT LOCATION: _
Address: 12060 Riverbend Rd Port St Lucie, FL 34984
Legal Description: BAY ST LUCIE LOT 11 (SUBJ TO ESMT TO C AND SFFCD)(MAP 44/22N) (OR 2959-785;3528-2579)
Property Tax ID#: 4422-502-0015-000-7 Lot No.11
Site Plan Name: Block No.
Project Name: WILLIAM BETHEA
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
RE-ROOF . REMOVE EXISTING TILE ROOF INSTALL A NEW TILE ROOF.
PITCH 5/12
$35,000
3300 SQ FT
CONSTRUCTION`INFORMATION.
Additional work to be nertormed under t ispermit—check all that apply:
11HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers ❑Generator W1 Roof 12 Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction: s O� Utilities, Sewer Building Height:
OWNER/LESSEE CONTRACTOR: G'
Name William M Bethea Jr Name: JOSEPH KOLINOSKI
Address:12060 Riverbend Rd Company: ONSHORE ROOFING SPECIALISTS, INC
City: PSL State:FL Address: 4401 SE COMMERCE AVE
Zip Code: 34984 Fax: City: STUART State:FL
Phone No.757-581-8040 Zip Code: 34996 Fax: 283-1557
E-Mail: Phone No. 772-283-1505
Fill in fee simple Title Holder on next page(if different E-Mail: INFO@ONSHOREROOFING.COM
from the Owner listed above) State or County License: CCC1328994
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
M
SUPPLEM
ENTAL
AL CONSTRUCTION LIENIAW IiVFORMATION,,
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:
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
commencinR work or recording our Notice of Commencement.
s
Signatur o essee/Contractor as Agent for Owner Signature ractor/License Holder
STATE OF FLOR!! A STATE OF FLORIgQ►
COUNTY OF II�,1 /ln /C.__ COUNTY OF V l
The 4f?orgong instru t was cknowledged,b re me Thefor ing instru t nt was ac n wledge b fore me
thisay of ) 20 -Lb/ th day of 20 by
ANSAKln I a 0 [C-L
=peledg' ) (Na o pers n acknowle Bing
(Signature of NotT P lic-State of Florida) (Signature of Nota ub' --State of Florida) `
Personally Known K OR Produced Identification Personally Know OR Produced Identification
Type of Identification Produced Type of Identifi ation Produced
Commission No: a
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