HomeMy WebLinkAboutBUILDING PERMIT APPAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
ti `L LLLLL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential XX
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: ROOF REPLACEMENT
PROPOSED IMPROVEMENT LOCATION:
Address: 12775 NW MARINER CT., PALM CITY, FL 34990
Property Tax ID #: 4425-603-0025-000-9
Site Plan Name: MARINER VILLAGE HARBOUR RIDGE -PLAT 4-UNIT 13
Project Name: CROTTY
DETAILED DESCRIPTION OF WORK:
ROOF REPLACEMENT - TILE TO METAL PANELS
New Electrical Meter Second Electrical Meter
Lot No.
Block No.
I CONSTRUCTION INFORMATION: I
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction: 5000
Cost of Construction: $ 40000
Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof 6/12 Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name NINA GROTTY
Name: FRANK LEO
Address: 12775 NW MARINER CT.
Company: LEO ROOFING & CONSTRUCTION
City: PALM CITY State: _
Zip Code: 34990 Fax:
Phone No.
Address: 3804 BURNS RD., STE D
City: PALM BEACH GARDENS State: FL
Zip Code: 33410 Fax: (561) 935-9337
Phone No (561) 935-4979
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail leodevelopment@bellsouth.net
State or County License CCC1328402
If value of construction is 2500 or more, a RECORDED Notice or Commencement is regwrea.
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 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:
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 Count yy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contlict 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.
Si nature of Owner/ Lessee/Contracto s Agent for Owner
Signature of 'Contractor/License Holder
STATE OF FLORIDA p
STATE OF FL%;
2
COUNTY OF (eY, j?da 11�
COUNTY OF 1 f v�&W11
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
^Ph� sical Presence or Online Notarization
this o day of 202d by
✓ Ph sical Presence or Online Notarization
this day of 1�/L,/ 2026 by
L2a_ 2{ l
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Name of person making skatement.
Name of person making statement.
Personally Known OR Produced Identification ✓
Personally Known v OR Produced Identification
Type of Identification
Type of Identification
Produced FL AL
Produced
(Signature of Notary Public- Stat Florida I
(Signature of Notary Public- St of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.