HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLE I &IA I ar1M0rAED
Date: DATE. - umber:
Approved by
AFFORDABLE ATfAI ABLE
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Planning and Development Services
Residential
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Re -roof
PROPOSED IMPROVEMENT LOCATION:
Address: 4812 MYRTLE DR
i✓= FL 34982
Property Tax ID #: 3402-608--0151-000-2 Lot No. 7
Site Plan Name: SULLIVAN
Project Name: SULLIVAN
Block No. 43
DETAILED DESCRIPTION OF WORK:
REMOVE EXTING ROOF COVER / RE -NAIL ALL DECK UP TO CODE / INSTALL NEW PEEL & STICK UNDERLAYMENT
Install New Tamko / Heritage shingle
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
(Affidavit required)
_Mechanical — Gas Tank —Gas Piping _ Shutters Windows/Doors _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof 5/12 Pitch
Total Sq. Ft of Construction: 3,291 Sq. Ft. of First Floor: 3,291
Cost of Construction: $ 16,000.00 Utilities: —Sewer —Septic Building Height: 12'
OWNERAESSEE:
CONTRACTOR:
Name PAULA K WEINTRAUT
Name: Mauricio Orellana
Company:One construction & Roofing contractors
Address: 4812 MYRTLE DR
City: state: FI
Zip Code: 34982 Fax: N/A
Phone No. 772-349-9933
Address: 2139 SW Conant Avenue
City: PORT SAINT LUCIE State: FL
Zip Code: 34953 Fax: N/A
Phone No 772-240-9497
E-Mail: NIA
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail oneconstructionservices@yahoo.com
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:
DESIGNER/ENGINEER: x Not Applicable
MORTGAGE COMPANY: x 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 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 our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner �►�� N I MC�� 1����i
�\�1SSIONEIo'�
STATE OF FLORID �pO,�y29,z02y�.•
COUNTY OF
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Sworn to (or affirmed) and subscribed before me of Ph sical Presence or Online N n 5. s
this day of 20� by MCL�b � 9 '• 2A°dded+��°�,�`�'���.;
�i�'f'j •, ob/icUpO..•' O
®tic, STA►'E,3
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
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