HomeMy WebLinkAboutBartolone - Application NotarizedDESIGNER/ENGINEER:
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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:
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Address:
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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.
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 attornev before commencine work or rprordinrr vcrlir Nntirp of CnmmPnromPnt
41M.A -A
JSignure
Sign Iure of Own&TLe!Tsee/CAiractor as Agent for Owner
of Contra-or/License Holder
STATE OF FLORIDA——
JT,
STATE OF FLORIDA
5� L-`-� �- `
COUNTY OF
COUNTY OF • e.
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
---Physical Presence or Online Notarization
-- Physical Presence or Online Notarization
this i9L day of Nf r -� \ 2020 by
this I'l day of R P r\ 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known — OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Public- Sta
ure of Notary Public f 1 r i)
G tNotary Public Stale of Fublic
No. ` U� �aljartyne MontaGG
StateCommission
Sion No. (� R MontaMy
1
Commission GG t9
Expires 03/01/2022
69
869
'i ►�y Commission GG 791869
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE M G
I
COUNTER REVIEW REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
-
COMPLETED
ev.
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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/16/2021 Permit Number:
r`L LL LLB
� .
• Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1SS3 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -Roof
PROPOSED
Address: 410 Willows Ave, Port Saint Lucie, FL 34952
Property Tax ID #: 3419-510-0197-000-8 Lot No.8
Site Plan Name: RIVER PARK -UNIT 2- BLK 17 LOT 8 (MAP 34/22N) Block No. 17
Project Name: Bartolone, Stephanie - Re -Roof
Remove existing shingle roof down to decking, install self -adhering underlayment down to decking, install metal roof.
Remove and replace low -slope roof in back. Install 3-ply modified roof system.
New Electrical Meter Second Electric
tONSTRUCT1414YIN-'FORK4ATION:
Additional work to be performed under this per
Mechanical Gas Tank Gas
_ Electric v Plumbing _ Spri
Total Sq. Ft of Construction: 2,288
Cost of Construction: 5 13,443.00
OWNER/LESSEE:
Name Stephanie Bartolone
Address:410 Willows Ave
City: Port St Lucie S1
Zip Code: 34952 Fax:
Phone No.772-828-5542
E-Mail:
Fill in fee simple Title Holder on next page ( if c
from the Owner listed above)
If value of construction is 2500 or more, a RECORDEC
If value of HAVC is $7,500 or more, a RECORDED Noti