HomeMy WebLinkAboutPermit Appl for 3905 Avenue OAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dade:
Permit Number:
SC�o 1�"TCCC
L L ` �` � `R Building Permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax,-. (772) 462-1578
Commercial
PERMIT APPLICATION FOR: Re -roof
PROPOSED IMPROVEMENT LOCATION:
Address: 3905 Avenue OFort Pierce, FL 34947
Residential X
Property Tax I D #: 2405-601-0437-000.-6 !b
Site Plan Name: Jacksonk P
Project Name: Jackson A 4L
09
DETAILED DESCRIPTION OF WORK: Q� . !i " J
Remove exfiing roof shingle
Install new peel & slick underlayment
install new shingle / Tamko
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
Mechanical
Electric
Gas Tank
Plumbing
Total Sq. Ft of Construction: 1620
Cost of Construction: $ 91000.00
_Gas Piping
Sprinklers
Shutters
Generator
Now %J
(D in
0 tp a- LL -0
`
use
Windows/Doors Pond
Rood 3/12 Pitch
Sq. Ft. of First Floor: 1620
Utilities: _Sewer _Septic Building Height: 12
OWN-ER/'LESSEE:
CONTRACTOR:
Name Serita M Jackson
Name: Mauricio orellana
Address:3905 Avenue 0
Company: One construction & roofing contractors
city: Fort Pierce State:
Zip Code: 34947 fax:
Address: 2139 sw Conant avenue
City.* port saint Lucie state: F1
Phone No. 772-987-0356
Zip Code: 34953 fax: N/A
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- 1330623
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:
DESIGN ER/ x Not Applicable MORTGAGE COMPANY.—-
x Not Applicable
Name: Name:
Address: .�-� Address:
City: ,-- ����� ,. State. City: _ _.�Stake:
Zip: � `� Phone dip: Phone:
FEE SIMPLE TITLE 14"OLDg Not Applicable BONDING COMPANY: Not Applicably
Name: Name:
Address: Address:
city: city:
Zip: Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVITO, 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 confict 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 jeobsite before the first inspection. if you intend to obtain financing, consult
with lender or an attorney before commencing,work or recordin our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/license Holder
STATE OF FLORIDA STATE OF FLORI A
COUNTY OF f LUtU., COUNTY OF
000
Sworn to (or affirmed) and subscribed before me of Swop to (or affirmed) and subscribed before me of
Physical Presince or Online Notarization .� Physical Presence or online Notarization
i'-,is day of 1 2020 by this day of I 202$ by
V V
Name of person making statement. Name of person making statement.
Personally Known ✓ OR Produced Iden 'R�q��di��!!1 Personally Known �OR Produced Ide �g0schithpr
Type of Identification �ti���A0 ��`�S Type of Identification �'�� 0
.31 N OrJ OF
Pr duced � M�S��n 3, •,��'�' Produced �
�iyl pap a�� � r, ..,_..._ �� �.�. �ULY���O,y'.��L
.P.
Sn
10 0 1 1 110 "('P' 190
-via 0
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sips
V/ ) k f - Z-4
(Signature o46t'a y Public- Sate of FfaidS.J,AWW '• f3ignature of Notar Public- State of Fl s a:� 9,�'�
psoare
Commission No.ca. 7 �� •I'A
���•, Noissiw�°� �' ammissivn No � NtL
i�il+l11N
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6