HomeMy WebLinkAboutBuilding Permit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date
O
Permit Number:
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:SHINGLE TO SHINGLE
PROPOSED IMPROVEMENT LOCATION:
Address: 143 NE Jardain RD Port St Lucie, FL 34983
Property Tax ID#: 3419-565-0056-000-8
Site Plan Name: Fernandez Residence
Project Name: Fernandez Residence
DETAILED DESCRIPTION OF WORK
Re -Roof Shingle to Shingle And Flat Roof
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Lot No. LOT 20
Block No. BLK 78
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 X RoofO/12 and 2/12 Pitch
Total Sq. Ft of Construction: 20.25 Sq. Ft. of First Floor:
Cost of Construction: $ 5,000.00 Utilities: —Sewer —Septic Building Height: 11 FT
OWNER/LESSEE:
CONTRACTOR:
Name143 NE Jardain RD Port St Lucie, fl
Name: Cesar Sandoval
Address:143 NE Jardain RD FL 34983
Company:The Roofing General LLC
City: fort St Lucie State: FL
Zip Code: 34983 Fax:
Phone No. SAME
Address:4629 SE Dixie Hwy
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone N0772-266-9659
E-Mail:SAME
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-MailSamira@theroofinggeneral.com
State or County License
If value of construction is 2s0U or more, a Kt:LUKUtU N01ice or l.omrrlencenirrn t5 icyuncu.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City: State:
Zip: Phone
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY:
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phon(
Not Applicable
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 your Notice of Commencement.
FAarco A. Fernandez (Apr 19, 202114:04 EDT)
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contras is rise Ho er .
STATE OF FLORIDA
STATE OF FLORIDA
OF M 4✓+ %
COUNTY OF
COUNTY
Sworn to (or affirmed) and subscribed before me of
or affirmed) and subscribed before me of
Swz2o,�
Physical Presence or (/Online Notarization
Physical Presence or Online Notarization
this L day of /!% 2029 by
this �O ay of ?✓i ( 2020 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification !/
GOa e aE c oc\
Personally Known OR Produce
Type of Identification
��n
Type of Identification 0taryP�b\` n �GC'�a,
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Produced l!!'G/y
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(Signature of a
Ignature of fd ry Public- State
Notary PubhcState of Florida
rip�t�
Commission No. CesarAS�NWwal
Commission No. (a Ig731� (Seal)
V . y COMMISSion HH 075549
moo' Expires 12/29/2024
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ZONING
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DATE
RECEIVED
DATE
COMPLETED
Rev. 5T6/20